| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,407 |
3,956 |
$634K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,083 |
5,465 |
$589K |
| 99408 |
|
1,523 |
1,235 |
$143K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,012 |
984 |
$83K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
716 |
705 |
$55K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
619 |
589 |
$50K |
| D0220 |
Intraoral - periapical first radiographic image |
991 |
885 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
391 |
373 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
102 |
88 |
$15K |
| D7140 |
Extraction, erupted tooth or exposed root |
133 |
70 |
$14K |
| 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 |
588 |
526 |
$13K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
71 |
69 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
125 |
108 |
$10K |
| D0330 |
Panoramic radiographic image |
72 |
70 |
$9K |
| D0230 |
Intraoral - periapical each additional radiographic image |
340 |
278 |
$8K |
| D0272 |
Bitewings - two radiographic images |
171 |
166 |
$8K |
| 81025 |
|
639 |
609 |
$8K |
| D1110 |
Prophylaxis - adult |
123 |
123 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
67 |
56 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
86 |
75 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
54 |
50 |
$5K |
| 99384 |
|
59 |
51 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
76 |
76 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
47 |
38 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
69 |
68 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
156 |
137 |
$2K |
| 82962 |
|
263 |
249 |
$1K |
| 90480 |
|
40 |
38 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
52 |
42 |
$1K |
| 81003 |
|
225 |
197 |
$1K |
| 99383 |
|
16 |
14 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
14 |
$732.93 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
40 |
39 |
$535.47 |
| 0002A |
|
13 |
13 |
$478.40 |
| 0011A |
|
14 |
12 |
$441.60 |
| 99406 |
|
13 |
12 |
$388.36 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
237 |
182 |
$335.08 |
| 90686 |
|
12 |
12 |
$217.98 |
| 90461 |
|
14 |
14 |
$181.44 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
203 |
152 |
$105.88 |
| 90651 |
|
13 |
13 |
$104.91 |
| 3078F |
|
113 |
101 |
$90.00 |
| 3074F |
|
95 |
89 |
$70.00 |
| 3079F |
|
66 |
62 |
$50.00 |
| 3075F |
|
72 |
65 |
$50.00 |
| 96127 |
|
653 |
575 |
$38.99 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
37 |
27 |
$34.19 |
| 96161 |
|
13 |
12 |
$21.78 |
| 3077F |
|
16 |
13 |
$10.00 |
| 1159F |
|
315 |
291 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
29 |
25 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
305 |
261 |
$0.00 |
| 1160F |
|
13 |
12 |
$0.00 |
| 99072 |
|
12 |
12 |
$0.00 |
| 99443 |
|
19 |
14 |
$0.00 |
| 1000F |
|
503 |
443 |
$0.00 |
| 1126F |
|
450 |
410 |
$0.00 |
| 1125F |
|
75 |
66 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
19 |
15 |
$0.00 |
| 1036F |
|
15 |
12 |
$0.00 |