| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
83,418 |
73,772 |
$10.83M |
| D0999 |
Unspecified diagnostic procedure, by report |
31,846 |
29,121 |
$7.68M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,932 |
10,202 |
$1.64M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,354 |
6,487 |
$707K |
| H0031 |
Mental health assessment, by non-physician |
3,882 |
1,873 |
$548K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
4,238 |
2,626 |
$455K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12,687 |
12,477 |
$270K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,475 |
1,460 |
$258K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,355 |
1,321 |
$252K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,530 |
1,513 |
$245K |
| H0023 |
Behavioral health outreach service (planned approach to reach a targeted population) |
1,288 |
479 |
$202K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
713 |
700 |
$104K |
| 90791 |
Psychiatric diagnostic evaluation |
755 |
645 |
$87K |
| 90837 |
Psychotherapy, 53 minutes with patient |
551 |
382 |
$73K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
413 |
395 |
$69K |
| 90834 |
Psychotherapy, 45 minutes with patient |
549 |
338 |
$63K |
| 90686 |
|
3,040 |
2,981 |
$62K |
| 90832 |
Psychotherapy, 30 minutes with patient |
537 |
342 |
$62K |
| D0120 |
Periodic oral evaluation - established patient |
3,222 |
3,145 |
$56K |
| D1110 |
Prophylaxis - adult |
1,540 |
1,495 |
$48K |
| D1351 |
Sealant - per tooth |
3,644 |
1,342 |
$48K |
| 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 |
1,621 |
1,432 |
$45K |
| D0274 |
Bitewings - four radiographic images |
1,858 |
1,809 |
$44K |
| D0190 |
|
6,060 |
5,878 |
$43K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,194 |
4,099 |
$43K |
| D1353 |
|
1,596 |
755 |
$42K |
| D0220 |
Intraoral - periapical first radiographic image |
3,775 |
3,677 |
$35K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,456 |
1,432 |
$31K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
156 |
152 |
$31K |
| D1120 |
Prophylaxis - child |
1,028 |
1,006 |
$29K |
| 90461 |
|
2,040 |
2,020 |
$28K |
| D0330 |
Panoramic radiographic image |
639 |
626 |
$27K |
| D7140 |
Extraction, erupted tooth or exposed root |
254 |
121 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
221 |
210 |
$22K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
9,983 |
8,634 |
$20K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
542 |
537 |
$20K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
120 |
113 |
$20K |
| D0140 |
Limited oral evaluation - problem focused |
257 |
253 |
$11K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,410 |
2,362 |
$9K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
884 |
383 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
53 |
51 |
$7K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
328 |
280 |
$6K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
60 |
57 |
$5K |
| 99381 |
|
27 |
27 |
$5K |
| D1206 |
Topical application of fluoride varnish |
14,015 |
13,548 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
30 |
27 |
$3K |
| 99000 |
|
1,471 |
1,431 |
$2K |
| D9310 |
|
104 |
104 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
767 |
731 |
$2K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
55 |
51 |
$2K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
93 |
49 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
7,337 |
7,018 |
$1K |
| 90682 |
|
16 |
16 |
$793.72 |
| 0134A |
|
19 |
15 |
$768.36 |
| D0270 |
|
29 |
29 |
$429.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
24 |
$204.24 |
| 90715 |
|
37 |
37 |
$193.55 |
| 81003 |
|
1,291 |
1,250 |
$1.90 |
| 85018 |
|
763 |
752 |
$0.00 |
| 92551 |
|
761 |
757 |
$0.00 |
| 36416 |
|
1,199 |
1,140 |
$0.00 |
| 93000 |
|
13 |
13 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
92 |
91 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
59 |
51 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
100 |
99 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
13 |
13 |
$0.00 |
| 94761 |
|
40 |
39 |
$0.00 |
| D9995 |
|
37 |
37 |
$0.00 |
| 90732 |
|
12 |
12 |
$0.00 |
| 81025 |
|
632 |
609 |
$0.00 |
| 99173 |
|
699 |
692 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
182 |
182 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
14 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
12 |
12 |
$0.00 |
| 82948 |
|
16 |
15 |
$0.00 |