| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55,193 |
48,439 |
$8.47M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38,495 |
33,632 |
$6.03M |
| D0999 |
Unspecified diagnostic procedure, by report |
21,734 |
19,620 |
$5.62M |
| H0023 |
Behavioral health outreach service (planned approach to reach a targeted population) |
10,949 |
5,687 |
$574K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
7,053 |
3,793 |
$370K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,470 |
1,397 |
$263K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
812 |
787 |
$159K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
697 |
663 |
$136K |
| D1206 |
Topical application of fluoride varnish |
15,191 |
13,904 |
$117K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
686 |
629 |
$100K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
549 |
497 |
$87K |
| D0120 |
Periodic oral evaluation - established patient |
4,273 |
3,967 |
$37K |
| 99215 |
Prolong outpt/office vis |
301 |
248 |
$36K |
| H1005 |
Prenatal care, at-risk enhanced service package (includes h1001-h1004) |
38 |
38 |
$20K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15,497 |
13,672 |
$18K |
| D0272 |
Bitewings - two radiographic images |
1,730 |
1,590 |
$17K |
| D1120 |
Prophylaxis - child |
1,178 |
1,095 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,358 |
10,866 |
$13K |
| 36415 |
Collection of venous blood by venipuncture |
14,167 |
12,958 |
$12K |
| H0025 |
Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) |
219 |
124 |
$11K |
| 0072A |
|
226 |
222 |
$11K |
| D0190 |
|
1,949 |
1,785 |
$10K |
| D0274 |
Bitewings - four radiographic images |
953 |
903 |
$10K |
| 0071A |
|
218 |
212 |
$10K |
| 0002A |
|
227 |
214 |
$10K |
| D0145 |
Oral evaluation for a patient under three years of age |
712 |
639 |
$9K |
| 0124A |
|
142 |
138 |
$9K |
| D0330 |
Panoramic radiographic image |
359 |
326 |
$8K |
| 99000 |
|
21,267 |
19,397 |
$8K |
| 99349 |
|
41 |
40 |
$7K |
| D1110 |
Prophylaxis - adult |
327 |
277 |
$7K |
| 99381 |
|
41 |
40 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
34 |
30 |
$7K |
| D1354 |
|
390 |
87 |
$6K |
| 0001A |
|
151 |
138 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
1,165 |
1,057 |
$6K |
| 0054A |
|
143 |
129 |
$6K |
| 0064A |
|
146 |
134 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
160 |
154 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
151 |
118 |
$3K |
| 90686 |
|
6,070 |
5,818 |
$3K |
| 81002 |
|
4,016 |
3,140 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
76 |
31 |
$3K |
| 36416 |
|
5,124 |
4,785 |
$3K |
| 0052A |
|
44 |
41 |
$2K |
| D1351 |
Sealant - per tooth |
149 |
45 |
$2K |
| 0004A |
|
58 |
52 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
12 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,863 |
3,739 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
818 |
774 |
$1K |
| D0170 |
|
37 |
35 |
$1K |
| 0154A |
|
16 |
16 |
$926.55 |
| 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 |
86 |
80 |
$922.04 |
| 90832 |
Psychotherapy, 30 minutes with patient |
22 |
15 |
$840.14 |
| 0051A |
|
13 |
13 |
$763.47 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,216 |
1,163 |
$655.98 |
| D0230 |
Intraoral - periapical each additional radiographic image |
293 |
280 |
$600.00 |
| 90688 |
|
3,065 |
2,942 |
$591.16 |
| 90651 |
|
51 |
49 |
$574.02 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,791 |
1,721 |
$546.71 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
905 |
497 |
$448.62 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
87 |
84 |
$304.00 |
| D9995 |
|
14 |
14 |
$225.00 |
| 81025 |
|
276 |
246 |
$221.72 |
| 90677 |
|
26 |
26 |
$126.60 |
| D0270 |
|
19 |
15 |
$120.00 |
| 80053 |
Comprehensive metabolic panel |
489 |
467 |
$55.95 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
230 |
220 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,201 |
1,134 |
$0.00 |
| 90680 |
|
141 |
134 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
86 |
83 |
$0.00 |
| 85018 |
|
100 |
98 |
$0.00 |
| 90723 |
|
144 |
137 |
$0.00 |
| 90647 |
|
159 |
159 |
$0.00 |
| 91301 |
|
21 |
15 |
$0.00 |
| 91307 |
|
299 |
288 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
101 |
95 |
$0.00 |
| 82962 |
|
113 |
85 |
$0.00 |
| 87428 |
|
24 |
24 |
$0.00 |
| 90474 |
|
14 |
14 |
$0.00 |
| 86803 |
|
12 |
12 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$0.00 |
| 99383 |
|
12 |
12 |
$0.00 |
| 90461 |
|
900 |
877 |
$0.00 |
| 90670 |
|
539 |
523 |
$0.00 |
| 99408 |
|
38 |
13 |
$0.00 |
| 90700 |
|
15 |
15 |
$0.00 |
| 80061 |
Lipid panel |
117 |
114 |
$0.00 |
| 83655 |
|
15 |
15 |
$0.00 |
| D0460 |
|
14 |
14 |
$0.00 |
| 90633 |
|
26 |
26 |
$0.00 |
| 90687 |
|
72 |
71 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
12 |
$0.00 |
| 90473 |
|
12 |
12 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$0.00 |