| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,979 |
5,869 |
$142K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,844 |
2,857 |
$77K |
| H1000 |
Prenatal care, at-risk assessment |
1,456 |
951 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,191 |
744 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,845 |
854 |
$48K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,942 |
1,350 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
479 |
294 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
332 |
194 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,806 |
1,381 |
$10K |
| 93784 |
|
2,552 |
1,303 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
215 |
205 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
103 |
88 |
$6K |
| D7140 |
Extraction, erupted tooth or exposed root |
296 |
226 |
$6K |
| D1110 |
Prophylaxis - adult |
246 |
241 |
$6K |
| 99383 |
|
122 |
74 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
149 |
136 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
162 |
155 |
$5K |
| D1330 |
|
637 |
624 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
487 |
454 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
85 |
79 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
677 |
558 |
$4K |
| D0330 |
Panoramic radiographic image |
218 |
206 |
$3K |
| 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 |
1,603 |
1,217 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
3,572 |
2,477 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
309 |
257 |
$2K |
| D0274 |
Bitewings - four radiographic images |
369 |
353 |
$2K |
| 99384 |
|
31 |
31 |
$2K |
| D1120 |
Prophylaxis - child |
152 |
148 |
$2K |
| D0272 |
Bitewings - two radiographic images |
64 |
61 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
611 |
476 |
$1K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
146 |
69 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
17 |
14 |
$1K |
| D1999 |
|
18 |
18 |
$1K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
52 |
39 |
$976.35 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
13 |
$879.24 |
| 99382 |
|
12 |
12 |
$744.37 |
| 99381 |
|
25 |
15 |
$654.67 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
205 |
172 |
$625.94 |
| D0220 |
Intraoral - periapical first radiographic image |
537 |
505 |
$618.47 |
| 82962 |
|
404 |
326 |
$366.24 |
| D1206 |
Topical application of fluoride varnish |
354 |
346 |
$330.17 |
| 81000 |
|
481 |
355 |
$223.04 |
| 82947 |
|
330 |
215 |
$206.67 |
| 0011A |
|
13 |
12 |
$192.74 |
| 90461 |
|
2,000 |
506 |
$180.40 |
| 90670 |
|
989 |
337 |
$180.05 |
| 90715 |
|
126 |
76 |
$82.79 |
| 90686 |
|
733 |
196 |
$40.32 |
| 3008F |
|
3,889 |
2,410 |
$31.17 |
| 90674 |
|
58 |
32 |
$20.00 |
| 1126F |
|
4,335 |
3,150 |
$0.18 |
| 3078F |
|
6,338 |
4,051 |
$0.17 |
| 1160F |
|
8,510 |
6,183 |
$0.11 |
| 1159F |
|
8,465 |
6,119 |
$0.10 |
| 3074F |
|
7,091 |
4,551 |
$0.06 |
| 1125F |
|
844 |
517 |
$0.03 |
| 1111F |
|
31 |
30 |
$0.01 |
| 3075F |
|
485 |
394 |
$0.01 |
| 3725F |
|
3,153 |
1,902 |
$0.00 |
| 1158F |
|
595 |
322 |
$0.00 |
| 1033F |
|
1,028 |
731 |
$0.00 |
| 90734 |
|
98 |
33 |
$0.00 |
| 99173 |
|
1,063 |
771 |
$0.00 |
| 3077F |
|
52 |
26 |
$0.00 |
| 0521F |
|
146 |
115 |
$0.00 |
| 4004F |
|
709 |
510 |
$0.00 |
| 90633 |
|
415 |
179 |
$0.00 |
| 90713 |
|
86 |
27 |
$0.00 |
| 90697 |
|
78 |
26 |
$0.00 |
| 3079F |
|
1,390 |
917 |
$0.00 |
| 90716 |
|
40 |
38 |
$0.00 |
| 92551 |
|
1,318 |
893 |
$0.00 |
| 1036F |
|
3,004 |
2,272 |
$0.00 |
| 90698 |
|
424 |
142 |
$0.00 |
| 4000F |
|
75 |
56 |
$0.00 |
| 1170F |
|
312 |
254 |
$0.00 |
| 90680 |
|
154 |
70 |
$0.00 |
| 3080F |
|
60 |
25 |
$0.00 |
| 1034F |
|
685 |
556 |
$0.00 |
| 90651 |
|
162 |
89 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
20 |
13 |
$0.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
15 |
15 |
$0.00 |
| 90656 |
|
59 |
57 |
$0.00 |
| 90677 |
|
25 |
13 |
$0.00 |
| 90696 |
|
40 |
12 |
$0.00 |
| 90744 |
|
79 |
17 |
$0.00 |
| H0033 |
Oral medication administration, direct observation |
74 |
18 |
$0.00 |