| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55,048 |
35,510 |
$5.83M |
| 90832 |
Psychotherapy, 30 minutes with patient |
9,881 |
2,917 |
$1.23M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,616 |
7,016 |
$1.12M |
| D1110 |
Prophylaxis - adult |
4,308 |
2,730 |
$322K |
| D0120 |
Periodic oral evaluation - established patient |
7,113 |
3,751 |
$303K |
| 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 |
4,224 |
2,525 |
$229K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,142 |
1,300 |
$209K |
| 99441 |
|
1,026 |
701 |
$87K |
| D9110 |
|
1,029 |
681 |
$85K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
764 |
485 |
$78K |
| 99442 |
|
880 |
650 |
$77K |
| 97803 |
|
2,630 |
1,915 |
$74K |
| D0274 |
Bitewings - four radiographic images |
2,482 |
1,903 |
$69K |
| 99493 |
|
629 |
621 |
$65K |
| D0220 |
Intraoral - periapical first radiographic image |
2,298 |
1,567 |
$64K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
441 |
308 |
$56K |
| D0210 |
Intraoral - complete series of radiographic images |
1,138 |
813 |
$50K |
| 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 |
764 |
751 |
$48K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
381 |
228 |
$46K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
335 |
221 |
$38K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
344 |
197 |
$36K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,031 |
3,956 |
$32K |
| D0140 |
Limited oral evaluation - problem focused |
408 |
223 |
$30K |
| D1120 |
Prophylaxis - child |
369 |
206 |
$24K |
| 90682 |
|
495 |
468 |
$23K |
| 0011A |
|
353 |
350 |
$18K |
| 0012A |
|
303 |
303 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
177 |
79 |
$16K |
| 0064A |
|
288 |
288 |
$13K |
| D1208 |
Topical application of fluoride, excluding varnish |
456 |
278 |
$12K |
| 99385 |
|
79 |
50 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
158 |
98 |
$9K |
| T2022 |
Case management, per month |
145 |
141 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
82 |
39 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
53 |
27 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
634 |
595 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
71 |
30 |
$5K |
| 11721 |
|
285 |
283 |
$5K |
| 90658 |
|
375 |
334 |
$4K |
| 90656 |
|
180 |
136 |
$4K |
| 81001 |
|
74 |
22 |
$3K |
| 99492 |
|
27 |
27 |
$3K |
| 0134A |
|
75 |
74 |
$3K |
| 81025 |
|
55 |
25 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
164 |
159 |
$2K |
| 81002 |
|
33 |
12 |
$1K |
| 97802 |
|
261 |
259 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
69 |
69 |
$1K |
| 90686 |
|
168 |
147 |
$900.76 |
| D0230 |
Intraoral - periapical each additional radiographic image |
151 |
150 |
$782.64 |
| 91322 |
|
12 |
12 |
$777.00 |
| 92551 |
|
169 |
169 |
$757.04 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
14 |
14 |
$599.13 |
| 90461 |
|
24 |
24 |
$299.52 |
| 90480 |
|
12 |
12 |
$277.03 |
| 90630 |
|
16 |
16 |
$253.48 |
| 86701 |
|
24 |
24 |
$169.01 |
| 90715 |
|
12 |
12 |
$162.46 |
| 99402 |
|
34 |
33 |
$138.39 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$128.56 |
| 91301 |
|
488 |
483 |
$52.93 |
| 80061 |
Lipid panel |
25 |
25 |
$38.92 |
| 3077F |
|
388 |
345 |
$35.00 |
| 80053 |
Comprehensive metabolic panel |
30 |
30 |
$33.29 |
| 99408 |
|
79 |
75 |
$26.92 |
| 97804 |
|
438 |
435 |
$12.75 |
| 99173 |
|
119 |
119 |
$11.71 |
| 1125F |
|
926 |
856 |
$10.00 |
| 1159F |
|
1,173 |
1,069 |
$10.00 |
| 1160F |
|
1,170 |
1,067 |
$10.00 |
| 1126F |
|
2,084 |
1,916 |
$5.00 |
| 91306 |
|
220 |
220 |
$0.03 |
| 82043 |
|
13 |
13 |
$0.02 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
496 |
462 |
$0.02 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$0.02 |
| 82570 |
|
13 |
13 |
$0.02 |
| 3079F |
|
163 |
144 |
$0.00 |
| 3080F |
|
64 |
61 |
$0.00 |
| 3074F |
|
30 |
29 |
$0.00 |
| 3078F |
|
120 |
114 |
$0.00 |
| 91313 |
|
60 |
59 |
$0.00 |