| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63,223 |
52,016 |
$2.78M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,936 |
13,458 |
$997K |
| T1015 |
Clinic visit/encounter, all-inclusive |
48,252 |
40,749 |
$813K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,498 |
3,136 |
$261K |
| D1110 |
Prophylaxis - adult |
5,121 |
4,635 |
$201K |
| D9999 |
Unspecified adjunctive procedure, by report |
8,422 |
6,518 |
$200K |
| 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 |
8,512 |
6,709 |
$183K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,117 |
825 |
$121K |
| D0120 |
Periodic oral evaluation - established patient |
6,388 |
5,801 |
$121K |
| D0210 |
Intraoral - complete series of radiographic images |
2,489 |
2,147 |
$111K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,638 |
1,227 |
$101K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,275 |
2,927 |
$97K |
| D0274 |
Bitewings - four radiographic images |
3,215 |
2,863 |
$88K |
| D1206 |
Topical application of fluoride varnish |
4,392 |
4,060 |
$76K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,585 |
1,163 |
$68K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,170 |
1,053 |
$68K |
| D1120 |
Prophylaxis - child |
2,516 |
2,333 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
542 |
492 |
$56K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,960 |
1,713 |
$50K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
553 |
506 |
$41K |
| D0330 |
Panoramic radiographic image |
1,354 |
1,181 |
$41K |
| 92015 |
Determination of refractive state |
3,049 |
2,604 |
$35K |
| D0140 |
Limited oral evaluation - problem focused |
987 |
902 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
393 |
365 |
$30K |
| 96156 |
|
1,351 |
1,162 |
$28K |
| 59425 |
|
506 |
393 |
$28K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
356 |
314 |
$24K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
283 |
247 |
$21K |
| 96158 |
|
955 |
719 |
$20K |
| 0012A |
|
649 |
582 |
$20K |
| D0220 |
Intraoral - periapical first radiographic image |
1,874 |
1,654 |
$20K |
| 99215 |
Prolong outpt/office vis |
222 |
180 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
453 |
410 |
$18K |
| 0011A |
|
716 |
604 |
$18K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
217 |
184 |
$17K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,391 |
3,071 |
$15K |
| D0272 |
Bitewings - two radiographic images |
810 |
751 |
$15K |
| 90832 |
Psychotherapy, 30 minutes with patient |
298 |
243 |
$12K |
| 0064A |
|
435 |
343 |
$12K |
| 0031A |
|
444 |
372 |
$11K |
| 0001A |
|
321 |
297 |
$10K |
| 0002A |
|
296 |
278 |
$10K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
194 |
180 |
$9K |
| 96151 |
|
1,078 |
765 |
$9K |
| 96150 |
|
854 |
685 |
$7K |
| 0004A |
|
223 |
196 |
$7K |
| 0124A |
|
293 |
186 |
$6K |
| D2331 |
|
86 |
65 |
$6K |
| 99384 |
|
82 |
70 |
$6K |
| 99382 |
|
58 |
56 |
$5K |
| 81002 |
|
2,779 |
1,913 |
$5K |
| 0071A |
|
154 |
135 |
$5K |
| 0072A |
|
132 |
130 |
$5K |
| 90688 |
|
567 |
538 |
$4K |
| 99381 |
|
45 |
45 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
388 |
352 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
36 |
31 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
25 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
286 |
261 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
78 |
76 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
268 |
238 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
126 |
110 |
$2K |
| 0034A |
|
135 |
50 |
$2K |
| 59426 |
|
21 |
12 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
28 |
25 |
$2K |
| D2330 |
|
36 |
25 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
41 |
41 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
83 |
40 |
$1K |
| 11721 |
|
92 |
82 |
$1K |
| D4910 |
|
49 |
37 |
$1K |
| D0270 |
|
58 |
53 |
$1K |
| 90480 |
|
106 |
30 |
$934.80 |
| 99383 |
|
15 |
12 |
$925.00 |
| 81025 |
|
365 |
319 |
$905.06 |
| 99460 |
|
29 |
15 |
$892.99 |
| D1208 |
Topical application of fluoride, excluding varnish |
162 |
154 |
$783.65 |
| 90686 |
|
1,289 |
1,194 |
$773.68 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
27 |
14 |
$522.85 |
| 94760 |
|
434 |
364 |
$464.11 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
95 |
79 |
$440.97 |
| 92250 |
|
13 |
12 |
$339.72 |
| D0230 |
Intraoral - periapical each additional radiographic image |
60 |
26 |
$335.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
52 |
25 |
$252.51 |
| 80305 |
|
96 |
80 |
$173.18 |
| 80061 |
Lipid panel |
13 |
12 |
$112.43 |
| 90474 |
|
14 |
14 |
$96.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
86 |
83 |
$87.00 |
| 36415 |
Collection of venous blood by venipuncture |
37 |
31 |
$64.40 |
| 82274 |
|
26 |
26 |
$51.50 |
| D1351 |
Sealant - per tooth |
49 |
16 |
$29.35 |
| 99386 |
|
12 |
12 |
$0.00 |
| 90651 |
|
36 |
33 |
$0.00 |
| 99385 |
|
137 |
121 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$0.00 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
15 |
15 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
46 |
43 |
$0.00 |
| 90656 |
|
18 |
18 |
$0.00 |
| 90680 |
|
25 |
25 |
$0.00 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
14 |
12 |
$0.00 |
| 92551 |
|
24 |
22 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90670 |
|
146 |
139 |
$0.00 |
| 90700 |
|
29 |
26 |
$0.00 |
| 90713 |
|
13 |
13 |
$0.00 |
| 90648 |
|
42 |
39 |
$0.00 |
| 90658 |
|
65 |
60 |
$0.00 |
| 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 |
39 |
25 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
14 |
14 |
$0.00 |
| 91320 |
|
111 |
41 |
$0.00 |
| 90633 |
|
21 |
17 |
$0.00 |