| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
90,408 |
52,009 |
$6.51M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,858 |
5,566 |
$741K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,679 |
1,697 |
$463K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,238 |
1,757 |
$426K |
| D1110 |
Prophylaxis - adult |
11,976 |
3,926 |
$423K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,773 |
2,899 |
$394K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,153 |
2,192 |
$289K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,334 |
2,291 |
$287K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,829 |
1,683 |
$241K |
| D0120 |
Periodic oral evaluation - established patient |
9,075 |
4,165 |
$220K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,025 |
1,374 |
$197K |
| 99443 |
|
1,490 |
826 |
$180K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,261 |
1,336 |
$175K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,183 |
1,167 |
$157K |
| 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 |
2,173 |
2,159 |
$149K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,359 |
857 |
$114K |
| 99442 |
|
1,245 |
960 |
$103K |
| D0140 |
Limited oral evaluation - problem focused |
2,322 |
1,088 |
$99K |
| 82948 |
|
4,819 |
3,403 |
$91K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,249 |
521 |
$76K |
| 92002 |
|
1,068 |
530 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,043 |
501 |
$64K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,080 |
745 |
$62K |
| 99441 |
|
626 |
446 |
$58K |
| D1120 |
Prophylaxis - child |
1,520 |
495 |
$43K |
| D0210 |
Intraoral - complete series of radiographic images |
991 |
506 |
$42K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
569 |
281 |
$39K |
| 81003 |
|
2,011 |
1,252 |
$37K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
347 |
213 |
$36K |
| 81025 |
|
1,729 |
1,253 |
$31K |
| D0220 |
Intraoral - periapical first radiographic image |
2,751 |
2,725 |
$26K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
311 |
179 |
$26K |
| D0274 |
Bitewings - four radiographic images |
1,273 |
1,202 |
$26K |
| 92015 |
Determination of refractive state |
2,774 |
2,557 |
$24K |
| 97802 |
|
1,967 |
1,961 |
$22K |
| D0603 |
|
746 |
118 |
$16K |
| 90686 |
|
1,173 |
1,080 |
$13K |
| 97803 |
|
452 |
441 |
$13K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,856 |
1,744 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,334 |
1,273 |
$12K |
| 11721 |
|
467 |
395 |
$12K |
| 96127 |
|
1,153 |
1,033 |
$11K |
| 99173 |
|
1,548 |
1,187 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
373 |
68 |
$9K |
| 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 |
390 |
281 |
$8K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
77 |
52 |
$7K |
| 92250 |
|
172 |
81 |
$7K |
| 92100 |
|
148 |
126 |
$6K |
| 99215 |
Prolong outpt/office vis |
44 |
25 |
$6K |
| 92551 |
|
1,354 |
1,264 |
$5K |
| 2022F |
|
431 |
360 |
$5K |
| 0011A |
|
177 |
174 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
33 |
24 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
55 |
26 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
921 |
914 |
$3K |
| 92133 |
|
67 |
41 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
13 |
13 |
$2K |
| D0602 |
|
76 |
13 |
$2K |
| D9110 |
|
46 |
12 |
$1K |
| 90658 |
|
237 |
237 |
$1K |
| 0012A |
|
37 |
37 |
$1K |
| D1206 |
Topical application of fluoride varnish |
39 |
39 |
$985.50 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
23 |
14 |
$817.41 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
57 |
$471.05 |
| 90461 |
|
289 |
287 |
$228.28 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
13 |
12 |
$222.93 |
| H0049 |
Alcohol and/or drug screening |
98 |
98 |
$110.40 |
| 90670 |
|
80 |
79 |
$30.00 |
| 91301 |
|
253 |
253 |
$0.12 |
| 90655 |
|
13 |
13 |
$0.00 |
| 90863 |
|
74 |
72 |
$0.00 |
| 90633 |
|
25 |
25 |
$0.00 |
| 3008F |
|
34 |
34 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| D0601 |
|
171 |
171 |
$0.00 |
| 90698 |
|
14 |
13 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |