| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,713 |
8,090 |
$807K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,858 |
2,376 |
$186K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
766 |
519 |
$50K |
| D0999 |
Unspecified diagnostic procedure, by report |
263 |
263 |
$35K |
| D0330 |
Panoramic radiographic image |
453 |
405 |
$24K |
| 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 |
2,975 |
2,077 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
130 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44 |
39 |
$4K |
| D1120 |
Prophylaxis - child |
361 |
324 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
79 |
71 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
2,752 |
2,194 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
193 |
176 |
$961.00 |
| D0272 |
Bitewings - two radiographic images |
15 |
12 |
$550.25 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
35 |
29 |
$220.10 |
| 85027 |
|
1,198 |
1,056 |
$212.82 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,910 |
2,551 |
$44.16 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,068 |
932 |
$33.10 |
| 87428 |
|
1,278 |
1,111 |
$18.01 |
| 81000 |
|
108 |
91 |
$13.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,360 |
1,272 |
$12.20 |
| G0008 |
Administration of influenza virus vaccine |
139 |
108 |
$9.50 |
| 80305 |
|
78 |
53 |
$7.56 |
| 90686 |
|
35 |
35 |
$2.50 |
| 90671 |
|
127 |
119 |
$0.12 |
| 99000 |
|
807 |
717 |
$0.00 |
| 90474 |
|
81 |
78 |
$0.00 |
| A9150 |
Non-prescription drugs |
44 |
40 |
$0.00 |
| 90697 |
|
60 |
57 |
$0.00 |
| 90680 |
|
81 |
79 |
$0.00 |
| 36416 |
|
133 |
103 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
84 |
78 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
13 |
12 |
$0.00 |
| 90723 |
|
26 |
26 |
$0.00 |
| 90670 |
|
198 |
186 |
$0.00 |
| 87420 |
|
275 |
240 |
$0.00 |
| 99071 |
|
203 |
189 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
995 |
930 |
$0.00 |
| 81025 |
|
12 |
12 |
$0.00 |
| 90648 |
|
86 |
86 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
122 |
116 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |
| 81002 |
|
16 |
14 |
$0.00 |
| 90681 |
|
14 |
12 |
$0.00 |