| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,419 |
12,165 |
$1.20M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,746 |
3,929 |
$273K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,335 |
1,808 |
$159K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
912 |
850 |
$95K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
518 |
470 |
$55K |
| 99215 |
Prolong outpt/office vis |
593 |
517 |
$43K |
| 59425 |
|
369 |
223 |
$32K |
| 99382 |
|
315 |
286 |
$30K |
| 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 |
6,244 |
4,816 |
$27K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
217 |
179 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
287 |
182 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
133 |
111 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
107 |
94 |
$10K |
| 59426 |
|
118 |
49 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,830 |
3,209 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
182 |
126 |
$9K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,435 |
2,010 |
$8K |
| 99383 |
|
113 |
87 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
2,126 |
1,779 |
$7K |
| 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 |
566 |
561 |
$6K |
| 81003 |
|
2,630 |
1,771 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
84 |
73 |
$6K |
| 99384 |
|
65 |
50 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,518 |
2,132 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
41 |
41 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
82 |
55 |
$3K |
| 87430 |
|
769 |
660 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,048 |
1,606 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
67 |
61 |
$2K |
| 99460 |
|
24 |
24 |
$2K |
| D0330 |
Panoramic radiographic image |
56 |
44 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
56 |
39 |
$2K |
| 87280 |
|
557 |
515 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
251 |
212 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$1K |
| 99441 |
|
42 |
38 |
$863.58 |
| 85018 |
|
630 |
584 |
$812.28 |
| 99173 |
|
1,084 |
935 |
$734.89 |
| 81025 |
|
1,106 |
903 |
$710.43 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
218 |
193 |
$684.11 |
| 90630 |
|
128 |
109 |
$604.40 |
| 92551 |
|
1,073 |
918 |
$512.27 |
| 84703 |
|
241 |
202 |
$483.52 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
269 |
231 |
$400.61 |
| D1206 |
Topical application of fluoride varnish |
30 |
30 |
$368.07 |
| 99401 |
|
69 |
61 |
$362.64 |
| 91321 |
|
128 |
109 |
$291.84 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
49 |
42 |
$241.76 |
| 90710 |
|
55 |
45 |
$241.76 |
| 90734 |
|
128 |
105 |
$241.76 |
| 0001A |
|
34 |
32 |
$179.35 |
| 90480 |
|
220 |
190 |
$171.70 |
| 90474 |
|
330 |
273 |
$134.35 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$122.69 |
| 90696 |
|
59 |
49 |
$120.88 |
| 90651 |
|
255 |
209 |
$102.57 |
| 0071A |
|
28 |
27 |
$35.58 |
| 90686 |
|
973 |
837 |
$19.36 |
| 90649 |
|
21 |
19 |
$10.00 |
| 90680 |
|
430 |
361 |
$0.78 |
| 90633 |
|
688 |
596 |
$0.52 |
| 90671 |
|
237 |
184 |
$0.43 |
| 90700 |
|
15 |
12 |
$0.03 |
| 90697 |
|
268 |
218 |
$0.00 |
| 90688 |
|
274 |
258 |
$0.00 |
| 81001 |
|
171 |
92 |
$0.00 |
| 91301 |
|
79 |
77 |
$0.00 |
| 91307 |
|
33 |
33 |
$0.00 |
| 1170F |
|
46 |
39 |
$0.00 |
| 90656 |
|
26 |
25 |
$0.00 |
| 36416 |
|
122 |
113 |
$0.00 |
| 90716 |
|
29 |
28 |
$0.00 |
| 0011A |
|
52 |
49 |
$0.00 |
| 96161 |
|
12 |
12 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
12 |
$0.00 |
| D1351 |
Sealant - per tooth |
48 |
16 |
$0.00 |
| 0012A |
|
29 |
29 |
$0.00 |
| 0072A |
|
16 |
15 |
$0.00 |
| 3074F |
|
13 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
416 |
345 |
$0.00 |
| 90670 |
|
195 |
161 |
$0.00 |
| 90715 |
|
169 |
139 |
$0.00 |
| 81002 |
|
322 |
193 |
$0.00 |
| 90461 |
|
74 |
62 |
$0.00 |
| 3078F |
|
360 |
307 |
$0.00 |
| 91300 |
|
51 |
44 |
$0.00 |
| 1159F |
|
80 |
73 |
$0.00 |
| 90685 |
|
24 |
14 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
36 |
27 |
$0.00 |
| 90707 |
|
27 |
26 |
$0.00 |
| 87210 |
|
17 |
12 |
$0.00 |
| 83655 |
|
15 |
15 |
$0.00 |