| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,554 |
9,248 |
$708K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,108 |
6,721 |
$632K |
| T1017 |
Targeted case management, each 15 minutes |
1,334 |
1,020 |
$527K |
| D0140 |
Limited oral evaluation - problem focused |
4,948 |
4,666 |
$279K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,738 |
3,597 |
$222K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,504 |
1,933 |
$193K |
| D1110 |
Prophylaxis - adult |
2,970 |
2,944 |
$170K |
| D0330 |
Panoramic radiographic image |
4,556 |
4,371 |
$123K |
| D0120 |
Periodic oral evaluation - established patient |
3,095 |
3,066 |
$120K |
| 90837 |
Psychotherapy, 53 minutes with patient |
809 |
556 |
$116K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,116 |
636 |
$116K |
| D1206 |
Topical application of fluoride varnish |
5,446 |
5,254 |
$108K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,720 |
1,530 |
$102K |
| D1120 |
Prophylaxis - child |
1,803 |
1,766 |
$80K |
| D1351 |
Sealant - per tooth |
2,663 |
845 |
$72K |
| 90791 |
Psychiatric diagnostic evaluation |
553 |
509 |
$66K |
| D0274 |
Bitewings - four radiographic images |
3,387 |
3,288 |
$62K |
| D0230 |
Intraoral - periapical each additional radiographic image |
8,581 |
2,752 |
$61K |
| D0220 |
Intraoral - periapical first radiographic image |
4,836 |
4,648 |
$61K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,032 |
660 |
$56K |
| D0191 |
|
1,765 |
1,751 |
$39K |
| D4341 |
|
362 |
198 |
$33K |
| D0210 |
Intraoral - complete series of radiographic images |
616 |
613 |
$26K |
| D2940 |
|
549 |
224 |
$24K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
293 |
239 |
$21K |
| 96152 |
|
349 |
271 |
$20K |
| D4342 |
|
280 |
127 |
$19K |
| D4910 |
|
365 |
364 |
$18K |
| 0011A |
|
376 |
370 |
$17K |
| 0012A |
|
363 |
359 |
$16K |
| D1208 |
Topical application of fluoride, excluding varnish |
744 |
741 |
$14K |
| 90686 |
|
785 |
770 |
$14K |
| 90834 |
Psychotherapy, 45 minutes with patient |
131 |
117 |
$13K |
| D1354 |
|
2,678 |
599 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
397 |
387 |
$13K |
| D4346 |
|
208 |
195 |
$12K |
| 0064A |
|
258 |
249 |
$10K |
| 80305 |
|
1,217 |
867 |
$10K |
| G9011 |
Coordinated care fee, risk adjusted maintenance, level 5 |
207 |
155 |
$8K |
| 0001A |
|
144 |
136 |
$8K |
| 0002A |
|
124 |
117 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
162 |
144 |
$8K |
| D4355 |
|
83 |
83 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
49 |
47 |
$5K |
| 96158 |
|
131 |
110 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
45 |
41 |
$5K |
| T1015 |
Clinic visit/encounter, all-inclusive |
46 |
45 |
$4K |
| 99442 |
|
50 |
46 |
$4K |
| 0071A |
|
98 |
94 |
$4K |
| 99441 |
|
60 |
58 |
$4K |
| 0072A |
|
87 |
83 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
64 |
56 |
$3K |
| 0031A |
|
76 |
69 |
$3K |
| 90480 |
|
122 |
118 |
$3K |
| 90688 |
|
173 |
173 |
$3K |
| 99215 |
Prolong outpt/office vis |
40 |
25 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
463 |
443 |
$3K |
| 0124A |
|
74 |
73 |
$2K |
| 91322 |
|
38 |
38 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
18 |
$2K |
| D2330 |
|
31 |
24 |
$2K |
| 97802 |
|
29 |
29 |
$2K |
| 96150 |
|
25 |
25 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
251 |
239 |
$1K |
| D2331 |
|
14 |
12 |
$1K |
| 0004A |
|
39 |
37 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$1K |
| D9995 |
|
33 |
32 |
$1K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
13 |
12 |
$1K |
| 80061 |
Lipid panel |
126 |
115 |
$987.85 |
| 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 |
123 |
86 |
$846.36 |
| 0134A |
|
35 |
31 |
$800.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
25 |
25 |
$702.90 |
| 90672 |
|
32 |
32 |
$692.34 |
| 96160 |
|
201 |
189 |
$618.54 |
| 90656 |
|
37 |
37 |
$613.94 |
| 98968 |
|
15 |
12 |
$558.12 |
| 90715 |
|
29 |
29 |
$505.08 |
| D0602 |
|
198 |
197 |
$484.00 |
| D1355 |
|
178 |
12 |
$449.61 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
38 |
34 |
$393.85 |
| 90633 |
|
13 |
13 |
$285.48 |
| S4993 |
Contraceptive pills for birth control |
17 |
13 |
$201.78 |
| D0270 |
|
26 |
25 |
$200.00 |
| D0272 |
Bitewings - two radiographic images |
56 |
56 |
$196.00 |
| 99188 |
|
15 |
14 |
$181.58 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$160.75 |
| 99177 |
|
112 |
111 |
$154.90 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
16 |
$131.84 |
| D0603 |
|
456 |
434 |
$44.00 |
| 91312 |
|
72 |
69 |
$0.02 |
| D0350 |
|
508 |
462 |
$0.00 |
| D9990 |
|
188 |
181 |
$0.00 |
| D4921 |
|
42 |
12 |
$0.00 |
| 91313 |
|
29 |
28 |
$0.00 |
| D1330 |
|
6,172 |
5,853 |
$0.00 |
| D1310 |
|
2,196 |
2,144 |
$0.00 |
| D1353 |
|
27 |
12 |
$0.00 |