| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35,123 |
31,505 |
$1.50M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,191 |
5,668 |
$311K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,047 |
1,985 |
$196K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,002 |
1,830 |
$193K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,466 |
3,130 |
$145K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,527 |
1,477 |
$129K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,729 |
1,313 |
$111K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
910 |
885 |
$78K |
| D1110 |
Prophylaxis - adult |
1,819 |
1,784 |
$60K |
| D0330 |
Panoramic radiographic image |
1,330 |
1,312 |
$56K |
| D1120 |
Prophylaxis - child |
1,595 |
1,583 |
$53K |
| D0120 |
Periodic oral evaluation - established patient |
1,989 |
1,926 |
$36K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,167 |
708 |
$35K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
758 |
653 |
$33K |
| 90832 |
Psychotherapy, 30 minutes with patient |
644 |
524 |
$32K |
| D0274 |
Bitewings - four radiographic images |
1,717 |
1,670 |
$28K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
433 |
387 |
$26K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
411 |
378 |
$26K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,602 |
4,434 |
$24K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,968 |
2,615 |
$23K |
| D0140 |
Limited oral evaluation - problem focused |
2,324 |
2,256 |
$22K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,293 |
1,265 |
$21K |
| 99406 |
|
3,599 |
3,247 |
$19K |
| 90837 |
Psychotherapy, 53 minutes with patient |
161 |
102 |
$19K |
| 87428 |
|
488 |
478 |
$16K |
| D1351 |
Sealant - per tooth |
1,079 |
451 |
$16K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
477 |
361 |
$15K |
| 80305 |
|
3,595 |
3,229 |
$13K |
| D1206 |
Topical application of fluoride varnish |
3,227 |
3,199 |
$10K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
4,810 |
3,392 |
$10K |
| 99215 |
Prolong outpt/office vis |
137 |
123 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
114 |
106 |
$8K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
84 |
67 |
$6K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,078 |
1,058 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
779 |
752 |
$5K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
29 |
26 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
42 |
41 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
546 |
527 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
6,656 |
6,423 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
24 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,063 |
3,789 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
496 |
428 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
13 |
$2K |
| 0001A |
|
48 |
45 |
$2K |
| D0272 |
Bitewings - two radiographic images |
1,086 |
1,065 |
$1K |
| 99383 |
|
14 |
14 |
$1K |
| 0002A |
|
41 |
39 |
$1K |
| 0011A |
|
63 |
46 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
207 |
163 |
$1K |
| 0012A |
|
50 |
39 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
164 |
145 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
66 |
66 |
$1K |
| 90887 |
|
86 |
78 |
$1K |
| 99381 |
|
14 |
12 |
$1K |
| 98940 |
|
46 |
18 |
$1K |
| D1999 |
|
15 |
15 |
$900.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
12 |
12 |
$855.39 |
| 85018 |
|
737 |
719 |
$668.40 |
| 87806 |
|
115 |
110 |
$658.07 |
| 81003 |
|
480 |
468 |
$631.60 |
| 81002 |
|
715 |
688 |
$580.20 |
| 0031A |
|
21 |
17 |
$544.00 |
| 83655 |
|
80 |
79 |
$516.99 |
| 90686 |
|
400 |
387 |
$515.03 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
65 |
41 |
$464.86 |
| D0603 |
|
1,826 |
1,794 |
$385.00 |
| D1310 |
|
135 |
133 |
$358.20 |
| 1159F |
|
21,883 |
19,143 |
$284.60 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
104 |
90 |
$218.46 |
| 3008F |
|
2,959 |
2,579 |
$200.38 |
| 99188 |
|
14 |
14 |
$92.10 |
| 90461 |
|
191 |
185 |
$62.00 |
| 93000 |
|
12 |
12 |
$55.84 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
119 |
89 |
$55.11 |
| 3078F |
|
14,071 |
12,060 |
$53.72 |
| 96167 |
|
1,749 |
1,438 |
$48.57 |
| 81025 |
|
15 |
12 |
$42.08 |
| 97802 |
|
2,072 |
1,948 |
$32.57 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
2,155 |
1,877 |
$31.47 |
| D1330 |
|
156 |
153 |
$29.98 |
| 90715 |
|
118 |
113 |
$28.44 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a mental health visit |
36 |
25 |
$25.29 |
| 81001 |
|
46 |
45 |
$13.25 |
| 99408 |
|
2,153 |
1,824 |
$0.08 |
| 1125F |
|
5,080 |
4,620 |
$0.01 |
| 3079F |
|
5,188 |
4,628 |
$0.01 |
| 1170F |
|
714 |
655 |
$0.01 |
| 3077F |
|
1,530 |
1,390 |
$0.01 |
| 1160F |
|
21,846 |
19,096 |
$0.01 |
| 1000F |
|
15,706 |
13,457 |
$0.00 |
| 3074F |
|
15,878 |
14,311 |
$0.00 |
| 92551 |
|
2,760 |
2,369 |
$0.00 |
| 90647 |
|
594 |
565 |
$0.00 |
| 1126F |
|
7,321 |
6,586 |
$0.00 |
| 90723 |
|
583 |
561 |
$0.00 |
| 1036F |
|
12,037 |
10,358 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
6,457 |
5,449 |
$0.00 |
| 3075F |
|
2,298 |
2,140 |
$0.00 |
| 90651 |
|
403 |
389 |
$0.00 |
| 1111F |
|
566 |
483 |
$0.00 |
| 3080F |
|
787 |
715 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
16 |
16 |
$0.00 |
| 90677 |
|
123 |
123 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
1,429 |
1,267 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
92 |
89 |
$0.00 |
| 96127 |
|
137 |
123 |
$0.00 |
| 90696 |
|
28 |
26 |
$0.00 |
| 90620 |
|
14 |
12 |
$0.00 |
| 4010F |
|
56 |
55 |
$0.00 |
| 1034F |
|
26 |
26 |
$0.00 |
| 90889 |
|
19 |
17 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24 |
20 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
30 |
27 |
$0.00 |
| D0602 |
|
67 |
66 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
15 |
15 |
$0.00 |
| 1101F |
|
16 |
16 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
7,068 |
6,012 |
$0.00 |
| 3288F |
|
447 |
397 |
$0.00 |
| 90734 |
|
241 |
225 |
$0.00 |
| 1158F |
|
762 |
700 |
$0.00 |
| 2028F |
|
1,490 |
1,148 |
$0.00 |
| 90633 |
|
496 |
475 |
$0.00 |
| 90670 |
|
673 |
639 |
$0.00 |
| 90671 |
|
80 |
79 |
$0.00 |
| 99173 |
|
1,948 |
1,629 |
$0.00 |
| 96160 |
|
351 |
323 |
$0.00 |
| 90681 |
|
83 |
80 |
$0.00 |
| 90655 |
|
55 |
55 |
$0.00 |
| 83037 |
|
31 |
27 |
$0.00 |
| 90710 |
|
39 |
39 |
$0.00 |
| 4013F |
|
29 |
29 |
$0.00 |
| 90863 |
|
31 |
30 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
19 |
19 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
36 |
36 |
$0.00 |