| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,967 |
12,863 |
$416K |
| H1000 |
Prenatal care, at-risk assessment |
4,002 |
2,805 |
$164K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,364 |
1,927 |
$105K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,801 |
2,229 |
$95K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,512 |
1,255 |
$78K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,221 |
973 |
$67K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,407 |
1,370 |
$53K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,301 |
1,048 |
$46K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
581 |
523 |
$37K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,608 |
1,471 |
$23K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,396 |
3,020 |
$19K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
602 |
457 |
$17K |
| D0120 |
Periodic oral evaluation - established patient |
1,247 |
1,002 |
$17K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
544 |
505 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
277 |
221 |
$16K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,054 |
793 |
$15K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,736 |
1,534 |
$14K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
275 |
217 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
508 |
458 |
$12K |
| 90834 |
Psychotherapy, 45 minutes with patient |
232 |
161 |
$11K |
| 90791 |
Psychiatric diagnostic evaluation |
208 |
146 |
$11K |
| 59410 |
|
12 |
12 |
$10K |
| D1110 |
Prophylaxis - adult |
778 |
724 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
821 |
765 |
$7K |
| 87428 |
|
328 |
276 |
$6K |
| D1206 |
Topical application of fluoride varnish |
2,076 |
1,861 |
$5K |
| 90670 |
|
704 |
533 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
941 |
696 |
$4K |
| D1120 |
Prophylaxis - child |
249 |
232 |
$4K |
| 59430 |
|
102 |
68 |
$4K |
| 99215 |
Prolong outpt/office vis |
84 |
64 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
63 |
56 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
704 |
395 |
$3K |
| D0274 |
Bitewings - four radiographic images |
1,202 |
1,117 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
2,424 |
2,209 |
$3K |
| 99188 |
|
277 |
265 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,566 |
1,259 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
66 |
62 |
$2K |
| D1330 |
|
1,969 |
1,783 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
139 |
126 |
$1K |
| 81025 |
|
559 |
413 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
511 |
395 |
$1K |
| 90686 |
|
1,093 |
847 |
$1K |
| 81002 |
|
1,996 |
1,448 |
$1K |
| 90677 |
|
266 |
257 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
21 |
20 |
$899.50 |
| 90474 |
|
186 |
168 |
$695.98 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$695.06 |
| 76801 |
|
19 |
13 |
$454.63 |
| 2001F |
|
22,603 |
18,224 |
$371.15 |
| 1160F |
|
15,982 |
13,257 |
$371.15 |
| 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 |
413 |
273 |
$306.76 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
570 |
397 |
$231.79 |
| 86703 |
|
89 |
47 |
$201.26 |
| 90656 |
|
205 |
202 |
$200.01 |
| 3074F |
|
16,573 |
13,020 |
$190.57 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
27 |
$167.97 |
| 3078F |
|
14,525 |
11,139 |
$141.09 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
31 |
24 |
$138.20 |
| 36415 |
Collection of venous blood by venipuncture |
346 |
313 |
$137.91 |
| 82962 |
|
109 |
95 |
$134.05 |
| D0272 |
Bitewings - two radiographic images |
64 |
57 |
$133.15 |
| 3079F |
|
3,302 |
2,520 |
$124.51 |
| 85018 |
|
106 |
105 |
$97.75 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
21 |
20 |
$92.07 |
| D0603 |
|
1,332 |
1,233 |
$77.17 |
| 90723 |
|
728 |
589 |
$61.00 |
| 90651 |
|
199 |
166 |
$60.00 |
| 90674 |
|
51 |
46 |
$32.28 |
| 90734 |
|
27 |
26 |
$30.00 |
| 3075F |
|
882 |
749 |
$25.00 |
| 3044F |
|
778 |
668 |
$20.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
144 |
107 |
$9.72 |
| 3351F |
|
4,756 |
3,216 |
$0.09 |
| 1000F |
|
23,167 |
17,603 |
$0.02 |
| 3008F |
|
19,805 |
15,366 |
$0.01 |
| 2000F |
|
17,197 |
13,764 |
$0.00 |
| 1126F |
|
4,724 |
4,230 |
$0.00 |
| 1022F |
|
190 |
159 |
$0.00 |
| 1036F |
|
4,646 |
3,576 |
$0.00 |
| 1220F |
|
13,195 |
10,535 |
$0.00 |
| 90647 |
|
536 |
435 |
$0.00 |
| 4000F |
|
1,709 |
1,471 |
$0.00 |
| 1125F |
|
1,335 |
1,214 |
$0.00 |
| 92551 |
|
793 |
590 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
119 |
88 |
$0.00 |
| 4037F |
|
236 |
198 |
$0.00 |
| 96127 |
|
603 |
539 |
$0.00 |
| 1034F |
|
324 |
265 |
$0.00 |
| 36416 |
|
150 |
125 |
$0.00 |
| 1030F |
|
858 |
739 |
$0.00 |
| 99174 |
|
20 |
20 |
$0.00 |
| 4010F |
|
95 |
71 |
$0.00 |
| 3353F |
|
95 |
75 |
$0.00 |
| 0503F |
|
14 |
12 |
$0.00 |
| 1157F |
|
261 |
90 |
$0.00 |
| 91307 |
|
66 |
26 |
$0.00 |
| 3080F |
|
27 |
26 |
$0.00 |
| 3048F |
|
17 |
16 |
$0.00 |
| 99173 |
|
815 |
608 |
$0.00 |
| 1159F |
|
15,447 |
13,019 |
$0.00 |
| 0502F |
|
806 |
634 |
$0.00 |
| 1033F |
|
890 |
759 |
$0.00 |
| 90461 |
|
286 |
133 |
$0.00 |
| 3077F |
|
203 |
185 |
$0.00 |
| 3015F |
|
22 |
17 |
$0.00 |
| 3210F |
|
167 |
140 |
$0.00 |
| 4035F |
|
404 |
351 |
$0.00 |
| 99177 |
|
113 |
109 |
$0.00 |
| 4004F |
|
157 |
128 |
$0.00 |
| 4158F |
|
87 |
31 |
$0.00 |
| 4040F |
|
172 |
143 |
$0.00 |
| 90681 |
|
276 |
193 |
$0.00 |
| 90633 |
|
100 |
94 |
$0.00 |
| 2028F |
|
142 |
94 |
$0.00 |
| 98960 |
|
15 |
12 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
42 |
30 |
$0.00 |