| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44,322 |
30,471 |
$3.17M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,699 |
16,563 |
$1.64M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,008 |
5,138 |
$489K |
| D0120 |
Periodic oral evaluation - established patient |
27,559 |
9,189 |
$462K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,172 |
3,614 |
$385K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,287 |
2,791 |
$304K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,164 |
2,264 |
$249K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,707 |
2,119 |
$245K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,729 |
2,108 |
$216K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
3,184 |
1,973 |
$203K |
| D1110 |
Prophylaxis - adult |
3,875 |
3,526 |
$202K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,551 |
2,040 |
$202K |
| D1120 |
Prophylaxis - child |
3,530 |
3,080 |
$146K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,842 |
1,042 |
$143K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,221 |
7,198 |
$124K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,302 |
1,400 |
$112K |
| D0140 |
Limited oral evaluation - problem focused |
5,133 |
2,451 |
$102K |
| D0220 |
Intraoral - periapical first radiographic image |
6,654 |
5,895 |
$94K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,400 |
873 |
$93K |
| D0274 |
Bitewings - four radiographic images |
2,917 |
2,894 |
$81K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
870 |
681 |
$78K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
1,946 |
1,862 |
$62K |
| 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 |
4,461 |
1,963 |
$60K |
| 99385 |
|
618 |
418 |
$46K |
| 90791 |
Psychiatric diagnostic evaluation |
588 |
523 |
$45K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,380 |
4,286 |
$40K |
| D1206 |
Topical application of fluoride varnish |
729 |
690 |
$37K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
435 |
293 |
$35K |
| 90832 |
Psychotherapy, 30 minutes with patient |
779 |
510 |
$33K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
441 |
362 |
$32K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,131 |
2,101 |
$31K |
| D9430 |
|
409 |
356 |
$24K |
| 99386 |
|
270 |
155 |
$18K |
| 90686 |
|
2,689 |
2,675 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,153 |
3,147 |
$17K |
| 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 |
336 |
336 |
$16K |
| 99215 |
Prolong outpt/office vis |
260 |
154 |
$15K |
| 99406 |
|
3,685 |
3,533 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
175 |
98 |
$12K |
| 99442 |
|
312 |
280 |
$11K |
| 92552 |
|
3,175 |
3,173 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,028 |
1,027 |
$9K |
| D0272 |
Bitewings - two radiographic images |
518 |
512 |
$8K |
| 90715 |
|
199 |
199 |
$7K |
| D0210 |
Intraoral - complete series of radiographic images |
421 |
418 |
$7K |
| D4342 |
|
186 |
54 |
$6K |
| D4341 |
|
87 |
40 |
$6K |
| 99490 |
Ccm add 20min |
89 |
89 |
$5K |
| D0330 |
Panoramic radiographic image |
156 |
134 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
256 |
255 |
$4K |
| D2331 |
|
81 |
40 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
417 |
414 |
$4K |
| D0190 |
|
52 |
26 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
85 |
53 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,066 |
1,054 |
$3K |
| 99443 |
|
85 |
80 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
128 |
49 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,361 |
1,010 |
$3K |
| 99441 |
|
67 |
53 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
85 |
82 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
861 |
709 |
$2K |
| D9110 |
|
59 |
51 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
486 |
483 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
159 |
154 |
$2K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
72 |
29 |
$1K |
| 99460 |
|
12 |
12 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,060 |
1,059 |
$1K |
| 81002 |
|
930 |
906 |
$607.94 |
| 99173 |
|
2,144 |
2,144 |
$474.91 |
| 90651 |
|
273 |
273 |
$440.41 |
| 99051 |
|
206 |
201 |
$433.13 |
| 90620 |
|
83 |
82 |
$375.84 |
| 81025 |
|
331 |
326 |
$259.78 |
| 81003 |
|
894 |
885 |
$244.92 |
| 80305 |
|
41 |
38 |
$217.46 |
| 96127 |
|
846 |
832 |
$214.23 |
| 90656 |
|
30 |
30 |
$187.78 |
| D0270 |
|
13 |
13 |
$171.92 |
| 83655 |
|
77 |
77 |
$88.01 |
| 87807 |
|
39 |
39 |
$66.56 |
| 86580 |
|
14 |
12 |
$47.68 |
| 93000 |
|
12 |
12 |
$23.12 |
| 85018 |
|
80 |
80 |
$15.34 |
| 90670 |
|
545 |
545 |
$0.00 |
| 90648 |
|
241 |
241 |
$0.00 |
| 90734 |
|
238 |
237 |
$0.00 |
| 90633 |
|
124 |
124 |
$0.00 |
| 90685 |
|
71 |
71 |
$0.00 |
| 90723 |
|
86 |
86 |
$0.00 |
| 94760 |
|
1,420 |
1,368 |
$0.00 |
| 90677 |
|
67 |
67 |
$0.00 |
| 90698 |
|
102 |
102 |
$0.00 |
| 90680 |
|
181 |
181 |
$0.00 |
| 90744 |
|
26 |
26 |
$0.00 |