| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,478 |
20,367 |
$4.43M |
| T1015 |
Clinic visit/encounter, all-inclusive |
15,273 |
11,422 |
$1.74M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,162 |
4,881 |
$1.04M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,938 |
2,875 |
$617K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,199 |
2,826 |
$611K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,434 |
1,389 |
$292K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,048 |
957 |
$212K |
| 97803 |
|
774 |
717 |
$146K |
| 97802 |
|
489 |
474 |
$87K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
402 |
385 |
$83K |
| D1120 |
Prophylaxis - child |
2,159 |
2,159 |
$76K |
| D1110 |
Prophylaxis - adult |
1,422 |
1,422 |
$70K |
| 87428 |
|
983 |
945 |
$56K |
| D1206 |
Topical application of fluoride varnish |
3,123 |
3,123 |
$53K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,323 |
7,240 |
$52K |
| 90834 |
Psychotherapy, 45 minutes with patient |
208 |
166 |
$30K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
716 |
716 |
$29K |
| G9153 |
Mapcp demonstration - physician incentive pool |
578 |
577 |
$29K |
| D0120 |
Periodic oral evaluation - established patient |
1,060 |
1,060 |
$25K |
| D0140 |
Limited oral evaluation - problem focused |
576 |
574 |
$21K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
24 |
12 |
$21K |
| D0330 |
Panoramic radiographic image |
385 |
385 |
$20K |
| D0274 |
Bitewings - four radiographic images |
678 |
678 |
$19K |
| 90832 |
Psychotherapy, 30 minutes with patient |
98 |
63 |
$18K |
| 90791 |
Psychiatric diagnostic evaluation |
89 |
89 |
$16K |
| 59514 |
|
16 |
13 |
$16K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
361 |
263 |
$16K |
| 99383 |
|
80 |
73 |
$16K |
| 99188 |
|
2,545 |
2,538 |
$14K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
249 |
236 |
$12K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
173 |
168 |
$12K |
| D1351 |
Sealant - per tooth |
340 |
126 |
$11K |
| D0272 |
Bitewings - two radiographic images |
511 |
511 |
$10K |
| 0012A |
|
252 |
248 |
$10K |
| 0011A |
|
262 |
255 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
27 |
$5K |
| 92552 |
|
5,137 |
5,090 |
$5K |
| 0002A |
|
112 |
106 |
$4K |
| 0001A |
|
104 |
99 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
44 |
32 |
$4K |
| 0071A |
|
93 |
92 |
$4K |
| 0072A |
|
84 |
83 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
238 |
237 |
$3K |
| 99384 |
|
12 |
12 |
$2K |
| 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 |
63 |
62 |
$2K |
| 96160 |
|
206 |
206 |
$1K |
| 81002 |
|
2,353 |
1,944 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
13 |
12 |
$1K |
| 90677 |
|
407 |
407 |
$1K |
| 99460 |
|
13 |
13 |
$909.71 |
| 76801 |
|
18 |
13 |
$760.50 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12 |
12 |
$599.65 |
| 90686 |
|
2,019 |
2,010 |
$525.34 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,519 |
1,516 |
$461.02 |
| 0111A |
|
15 |
15 |
$440.00 |
| 90656 |
|
1,055 |
1,043 |
$263.22 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
28 |
27 |
$188.48 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
89 |
83 |
$185.09 |
| 87807 |
|
41 |
39 |
$159.47 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
116 |
111 |
$92.30 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
47 |
46 |
$57.22 |
| 80061 |
Lipid panel |
17 |
16 |
$55.74 |
| 90461 |
|
511 |
501 |
$39.87 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
102 |
99 |
$27.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
15 |
$20.86 |
| 81025 |
|
17 |
16 |
$6.72 |
| 96127 |
|
941 |
930 |
$0.01 |
| 90647 |
|
728 |
714 |
$0.00 |
| 90723 |
|
744 |
730 |
$0.00 |
| 91307 |
|
154 |
141 |
$0.00 |
| 92551 |
|
328 |
324 |
$0.00 |
| 91301 |
|
367 |
358 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
13 |
12 |
$0.00 |
| 90633 |
|
144 |
144 |
$0.00 |
| 99173 |
|
2,415 |
2,403 |
$0.00 |
| 90670 |
|
1,013 |
990 |
$0.00 |
| 91300 |
|
205 |
183 |
$0.00 |
| 90681 |
|
192 |
190 |
$0.00 |
| 90710 |
|
54 |
54 |
$0.00 |
| 86703 |
|
66 |
66 |
$0.00 |
| 91311 |
|
26 |
25 |
$0.00 |