| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,041 |
11,249 |
$784K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
3,124 |
2,767 |
$396K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,917 |
2,785 |
$276K |
| H0025 |
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) |
1,263 |
1,058 |
$159K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,211 |
5,037 |
$96K |
| D0190 |
|
5,449 |
5,284 |
$84K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
727 |
697 |
$66K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
1,793 |
1,722 |
$54K |
| 99177 |
|
3,339 |
3,236 |
$46K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
411 |
387 |
$42K |
| 92551 |
|
3,438 |
3,319 |
$37K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,364 |
3,198 |
$35K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,650 |
1,602 |
$33K |
| D0120 |
Periodic oral evaluation - established patient |
1,238 |
1,114 |
$28K |
| D1120 |
Prophylaxis - child |
805 |
735 |
$25K |
| D1206 |
Topical application of fluoride varnish |
1,400 |
1,269 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,290 |
1,240 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
206 |
198 |
$19K |
| D1110 |
Prophylaxis - adult |
426 |
381 |
$18K |
| 99215 |
Prolong outpt/office vis |
122 |
91 |
$15K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
96 |
96 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
98 |
98 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
240 |
235 |
$10K |
| D0274 |
Bitewings - four radiographic images |
315 |
282 |
$9K |
| 36415 |
Collection of venous blood by venipuncture |
2,705 |
2,607 |
$8K |
| 0071A |
|
174 |
159 |
$7K |
| 0072A |
|
120 |
119 |
$6K |
| D0145 |
Oral evaluation for a patient under three years of age |
183 |
180 |
$6K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
127 |
124 |
$5K |
| 90832 |
Psychotherapy, 30 minutes with patient |
87 |
86 |
$5K |
| 99173 |
|
454 |
445 |
$4K |
| 99000 |
|
1,487 |
1,395 |
$4K |
| 90686 |
|
1,192 |
1,163 |
$3K |
| 99385 |
|
25 |
25 |
$3K |
| 90473 |
|
138 |
138 |
$3K |
| 0012A |
|
67 |
66 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
31 |
28 |
$3K |
| 90651 |
|
111 |
105 |
$2K |
| 0011A |
|
60 |
60 |
$2K |
| 0001A |
|
83 |
81 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
18 |
12 |
$2K |
| 0002A |
|
45 |
40 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
69 |
66 |
$1K |
| 0124A |
|
16 |
16 |
$988.32 |
| D0180 |
|
16 |
12 |
$656.16 |
| 90688 |
|
711 |
701 |
$654.38 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
209 |
177 |
$641.01 |
| 81000 |
|
147 |
137 |
$562.71 |
| 90619 |
|
42 |
40 |
$555.00 |
| 90656 |
|
94 |
88 |
$499.20 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
25 |
$429.78 |
| 0064A |
|
12 |
12 |
$411.80 |
| D0272 |
Bitewings - two radiographic images |
13 |
13 |
$260.26 |
| 90715 |
|
14 |
12 |
$219.36 |
| 81025 |
|
24 |
24 |
$206.64 |
| 90474 |
|
70 |
70 |
$196.73 |
| 90734 |
|
26 |
26 |
$146.62 |
| 81002 |
|
15 |
13 |
$38.28 |
| 36416 |
|
12 |
12 |
$37.92 |
| 91300 |
|
225 |
161 |
$0.00 |
| 90670 |
|
15 |
13 |
$0.00 |
| 90672 |
|
275 |
226 |
$0.00 |
| 90621 |
|
63 |
61 |
$0.00 |
| 90648 |
|
15 |
13 |
$0.00 |
| 90685 |
|
15 |
13 |
$0.00 |
| 91312 |
|
16 |
16 |
$0.00 |
| 91307 |
|
299 |
211 |
$0.00 |
| 91301 |
|
163 |
149 |
$0.00 |