| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,772 |
27,367 |
$1.73M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,977 |
10,178 |
$893K |
| 90834 |
Psychotherapy, 45 minutes with patient |
13,145 |
6,567 |
$749K |
| T1015 |
Clinic visit/encounter, all-inclusive |
57,496 |
38,860 |
$459K |
| 59426 |
|
3,635 |
1,278 |
$221K |
| 59425 |
|
4,050 |
2,511 |
$213K |
| 90791 |
Psychiatric diagnostic evaluation |
1,348 |
1,099 |
$134K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,376 |
788 |
$128K |
| D1110 |
Prophylaxis - adult |
3,410 |
2,604 |
$125K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,637 |
1,357 |
$123K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,179 |
973 |
$101K |
| D9999 |
Unspecified adjunctive procedure, by report |
8,113 |
6,306 |
$86K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,428 |
2,830 |
$80K |
| D0120 |
Periodic oral evaluation - established patient |
4,583 |
3,504 |
$80K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,131 |
890 |
$77K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,317 |
469 |
$75K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,167 |
8,721 |
$71K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
918 |
679 |
$64K |
| D1120 |
Prophylaxis - child |
2,597 |
2,002 |
$64K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,367 |
1,803 |
$64K |
| D0330 |
Panoramic radiographic image |
1,605 |
1,186 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
891 |
709 |
$60K |
| D1206 |
Topical application of fluoride varnish |
3,789 |
2,928 |
$57K |
| D0274 |
Bitewings - four radiographic images |
1,796 |
1,347 |
$41K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,594 |
2,224 |
$40K |
| 90832 |
Psychotherapy, 30 minutes with patient |
825 |
555 |
$39K |
| D0210 |
Intraoral - complete series of radiographic images |
1,100 |
879 |
$36K |
| D0140 |
Limited oral evaluation - problem focused |
1,077 |
809 |
$32K |
| 59430 |
|
221 |
159 |
$31K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
478 |
291 |
$28K |
| V2020 |
Frames, purchases |
749 |
579 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
182 |
155 |
$19K |
| 92015 |
Determination of refractive state |
1,397 |
1,142 |
$19K |
| 81002 |
|
8,333 |
4,261 |
$18K |
| 92551 |
|
2,710 |
2,293 |
$15K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
316 |
190 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
266 |
230 |
$13K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
141 |
124 |
$11K |
| 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 |
533 |
394 |
$11K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
503 |
236 |
$10K |
| 99385 |
|
66 |
57 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
127 |
104 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
233 |
200 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
187 |
135 |
$5K |
| D1351 |
Sealant - per tooth |
197 |
39 |
$5K |
| 81025 |
|
751 |
552 |
$4K |
| 99173 |
|
2,940 |
2,479 |
$4K |
| 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 |
244 |
113 |
$3K |
| 97802 |
|
56 |
56 |
$3K |
| D4910 |
|
76 |
52 |
$3K |
| D0272 |
Bitewings - two radiographic images |
196 |
110 |
$3K |
| 99215 |
Prolong outpt/office vis |
34 |
26 |
$3K |
| 90651 |
|
324 |
257 |
$2K |
| 80305 |
|
204 |
126 |
$2K |
| 90686 |
|
1,911 |
1,439 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
371 |
289 |
$2K |
| 90461 |
|
440 |
263 |
$1K |
| D1354 |
|
39 |
13 |
$1K |
| 99354 |
|
32 |
28 |
$840.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
12 |
$838.11 |
| 99381 |
|
19 |
12 |
$682.40 |
| 90670 |
|
552 |
445 |
$649.23 |
| 90688 |
|
273 |
247 |
$627.82 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35 |
26 |
$531.57 |
| 99408 |
|
90 |
68 |
$423.27 |
| 81000 |
|
116 |
84 |
$413.39 |
| 90734 |
|
68 |
47 |
$410.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
60 |
56 |
$400.46 |
| 85018 |
|
282 |
205 |
$371.74 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
44 |
41 |
$272.32 |
| 82948 |
|
129 |
94 |
$239.10 |
| 90656 |
|
92 |
90 |
$220.44 |
| 90620 |
|
34 |
25 |
$216.89 |
| 87210 |
|
149 |
106 |
$137.92 |
| 90723 |
|
333 |
264 |
$120.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
20 |
13 |
$104.66 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
39 |
36 |
$89.19 |
| D0220 |
Intraoral - periapical first radiographic image |
317 |
267 |
$82.17 |
| 83655 |
|
16 |
13 |
$79.87 |
| 90633 |
|
102 |
85 |
$25.00 |
| 90648 |
|
633 |
483 |
$23.09 |
| 90707 |
|
29 |
15 |
$0.00 |
| 90710 |
|
29 |
26 |
$0.00 |
| 90681 |
|
88 |
77 |
$0.00 |
| D0270 |
|
12 |
12 |
$0.00 |
| 90715 |
|
28 |
17 |
$0.00 |
| 90677 |
|
50 |
46 |
$0.00 |
| 76801 |
|
18 |
12 |
$0.00 |
| 90697 |
|
27 |
25 |
$0.00 |
| 82962 |
|
32 |
25 |
$0.00 |
| 36416 |
|
15 |
13 |
$0.00 |