| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
79,690 |
68,331 |
$12.71M |
| D1206 |
Topical application of fluoride varnish |
40,701 |
38,808 |
$3.38M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,287 |
19,293 |
$3.04M |
| D1120 |
Prophylaxis - child |
15,653 |
14,930 |
$2.00M |
| G9150 |
National committee for quality assurance - level 3 medical home |
10,821 |
6,898 |
$1.89M |
| 90832 |
Psychotherapy, 30 minutes with patient |
10,007 |
7,444 |
$1.29M |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,993 |
5,370 |
$976K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,763 |
4,192 |
$872K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,500 |
4,446 |
$825K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,196 |
4,153 |
$781K |
| D1110 |
Prophylaxis - adult |
5,581 |
5,328 |
$742K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,265 |
3,195 |
$603K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,430 |
2,630 |
$541K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,654 |
3,307 |
$515K |
| D0140 |
Limited oral evaluation - problem focused |
4,340 |
4,056 |
$459K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,861 |
4,506 |
$412K |
| D0330 |
Panoramic radiographic image |
2,444 |
2,325 |
$349K |
| D7140 |
Extraction, erupted tooth or exposed root |
5,052 |
2,459 |
$344K |
| 90791 |
Psychiatric diagnostic evaluation |
2,209 |
2,087 |
$303K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
3,361 |
863 |
$283K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,702 |
1,817 |
$250K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,402 |
1,593 |
$187K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,814 |
1,750 |
$173K |
| S0311 |
Comprehensive management and care coordination for advanced illness, per calendar month |
1,697 |
1,157 |
$138K |
| D1351 |
Sealant - per tooth |
25,084 |
5,396 |
$132K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,115 |
1,099 |
$115K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
3,578 |
3,427 |
$115K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,684 |
1,633 |
$108K |
| D0120 |
Periodic oral evaluation - established patient |
6,970 |
6,609 |
$107K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
515 |
498 |
$74K |
| D0274 |
Bitewings - four radiographic images |
2,795 |
2,659 |
$70K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,609 |
3,254 |
$65K |
| D1354 |
|
6,567 |
2,113 |
$57K |
| 92551 |
|
6,346 |
6,214 |
$50K |
| D0210 |
Intraoral - complete series of radiographic images |
339 |
321 |
$49K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
315 |
307 |
$47K |
| D0145 |
Oral evaluation for a patient under three years of age |
527 |
510 |
$45K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,531 |
3,435 |
$44K |
| 99173 |
|
7,898 |
7,734 |
$43K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
606 |
473 |
$42K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12,645 |
12,190 |
$38K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
344 |
278 |
$38K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
177 |
168 |
$28K |
| D0220 |
Intraoral - periapical first radiographic image |
8,356 |
7,633 |
$21K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,552 |
1,453 |
$19K |
| D0272 |
Bitewings - two radiographic images |
4,642 |
4,307 |
$19K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,505 |
1,272 |
$15K |
| 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 |
14,223 |
10,487 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,547 |
2,479 |
$14K |
| T1015 |
Clinic visit/encounter, all-inclusive |
71 |
70 |
$13K |
| 99215 |
Prolong outpt/office vis |
118 |
116 |
$12K |
| 90686 |
|
5,064 |
4,841 |
$12K |
| Q3014 |
Telehealth originating site facility fee |
621 |
581 |
$11K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
407 |
200 |
$9K |
| S0221 |
Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care (patient is present); approximately 60 minutes |
218 |
170 |
$8K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
31 |
24 |
$7K |
| D0240 |
|
575 |
276 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,436 |
6,276 |
$6K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
159 |
144 |
$6K |
| D2940 |
|
164 |
82 |
$6K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
159 |
145 |
$6K |
| G9148 |
National committee for quality assurance - level 1 medical home |
88 |
72 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
8,094 |
3,553 |
$4K |
| 99384 |
|
19 |
19 |
$3K |
| 90651 |
|
1,427 |
1,367 |
$3K |
| D9420 |
|
29 |
27 |
$3K |
| 81025 |
|
423 |
397 |
$2K |
| 99381 |
|
12 |
12 |
$2K |
| 90670 |
|
2,428 |
2,405 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
317 |
308 |
$2K |
| 99307 |
|
36 |
26 |
$2K |
| D2330 |
|
41 |
26 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
49 |
47 |
$2K |
| D2331 |
|
35 |
27 |
$2K |
| 90710 |
|
1,529 |
1,488 |
$2K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
30 |
16 |
$2K |
| 87807 |
|
154 |
152 |
$2K |
| 90715 |
|
1,001 |
954 |
$2K |
| 81003 |
|
1,230 |
1,156 |
$1K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
1,860 |
1,283 |
$1K |
| 83655 |
|
107 |
105 |
$1K |
| 99460 |
|
15 |
15 |
$900.00 |
| D0270 |
|
1,078 |
1,017 |
$856.08 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
18 |
12 |
$847.55 |
| D2332 |
|
16 |
13 |
$761.80 |
| 97161 |
|
13 |
12 |
$564.64 |
| 98940 |
|
782 |
413 |
$559.65 |
| 90647 |
|
2,285 |
2,268 |
$459.90 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
15 |
14 |
$432.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
191 |
169 |
$381.23 |
| 87905 |
|
38 |
37 |
$367.63 |
| 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 |
983 |
808 |
$347.45 |
| 87634 |
|
17 |
17 |
$333.45 |
| 71046 |
Radiologic examination, chest; 2 views |
53 |
50 |
$323.33 |
| 90734 |
|
796 |
742 |
$253.00 |
| 87808 |
|
23 |
23 |
$228.05 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
85 |
85 |
$215.85 |
| 99406 |
|
16 |
13 |
$200.85 |
| 0071A |
|
22 |
22 |
$200.00 |
| 90696 |
|
422 |
404 |
$166.70 |
| 90620 |
|
120 |
113 |
$166.70 |
| 81002 |
|
169 |
119 |
$158.28 |
| 90723 |
|
2,227 |
2,208 |
$128.27 |
| 90680 |
|
1,801 |
1,788 |
$126.50 |
| 85018 |
|
91 |
87 |
$123.93 |
| 36415 |
Collection of venous blood by venipuncture |
4,806 |
4,522 |
$110.13 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16 |
15 |
$100.77 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
242 |
230 |
$83.56 |
| 90480 |
|
82 |
81 |
$20.26 |
| D0603 |
|
4,308 |
4,099 |
$18.30 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
45 |
43 |
$0.10 |
| D0191 |
|
3,837 |
3,723 |
$0.00 |
| 3078F |
|
481 |
436 |
$0.00 |
| 90700 |
|
277 |
273 |
$0.00 |
| 90633 |
|
1,704 |
1,666 |
$0.00 |
| 3077F |
|
26 |
24 |
$0.00 |
| 91322 |
|
12 |
12 |
$0.00 |
| 90662 |
|
25 |
24 |
$0.00 |
| 96167 |
|
31 |
26 |
$0.00 |
| 90685 |
|
44 |
43 |
$0.00 |
| 90677 |
|
509 |
504 |
$0.00 |
| 3074F |
|
175 |
157 |
$0.00 |
| 3075F |
|
327 |
298 |
$0.00 |
| 3079F |
|
519 |
454 |
$0.00 |
| D1330 |
|
399 |
395 |
$0.00 |
| 90619 |
|
109 |
109 |
$0.00 |
| 90656 |
|
261 |
261 |
$0.00 |
| D3120 |
|
27 |
26 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
129 |
123 |
$0.00 |
| D9995 |
|
20 |
20 |
$0.00 |
| 94760 |
|
299 |
213 |
$0.00 |
| 0001A |
|
15 |
13 |
$0.00 |
| D1353 |
|
467 |
155 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
25 |
24 |
$0.00 |