| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,220 |
1,987 |
$196K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,300 |
1,234 |
$126K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
295 |
277 |
$30K |
| 36415 |
Collection of venous blood by venipuncture |
952 |
937 |
$24K |
| 90832 |
Psychotherapy, 30 minutes with patient |
214 |
138 |
$8K |
| 92551 |
|
147 |
147 |
$6K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
101 |
41 |
$4K |
| 99401 |
|
156 |
156 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
368 |
363 |
$3K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
138 |
133 |
$2K |
| 99443 |
|
33 |
29 |
$2K |
| 86703 |
|
161 |
161 |
$2K |
| 92587 |
|
29 |
27 |
$909.54 |
| D0220 |
Intraoral - periapical first radiographic image |
64 |
64 |
$601.08 |
| D0120 |
Periodic oral evaluation - established patient |
29 |
29 |
$593.05 |
| D1120 |
Prophylaxis - child |
14 |
14 |
$474.00 |
| 99442 |
|
13 |
13 |
$440.00 |
| 3725F |
|
1,417 |
1,283 |
$390.00 |
| D0274 |
Bitewings - four radiographic images |
14 |
14 |
$282.75 |
| 1126F |
|
1,024 |
933 |
$260.00 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
57 |
25 |
$212.77 |
| 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 |
82 |
34 |
$203.33 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
106 |
104 |
$151.45 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$147.00 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
13 |
$129.50 |
| 90656 |
|
41 |
41 |
$91.21 |
| 90686 |
|
258 |
258 |
$73.13 |
| 1159F |
|
664 |
597 |
$10.00 |
| 3078F |
|
2,125 |
1,880 |
$0.00 |
| 1160F |
|
642 |
577 |
$0.00 |
| 3077F |
|
102 |
92 |
$0.00 |
| 99173 |
|
174 |
174 |
$0.00 |
| 3079F |
|
684 |
626 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
1,211 |
1,082 |
$0.00 |
| 3044F |
|
243 |
215 |
$0.00 |
| 3074F |
|
2,302 |
2,033 |
$0.00 |
| 3075F |
|
231 |
217 |
$0.00 |
| 3008F |
|
2,334 |
2,113 |
$0.00 |
| 1036F |
|
1,153 |
1,000 |
$0.00 |
| D0603 |
|
14 |
14 |
$0.00 |
| D1310 |
|
27 |
27 |
$0.00 |
| 1125F |
|
35 |
33 |
$0.00 |
| D1330 |
|
49 |
49 |
$0.00 |
| 1034F |
|
31 |
26 |
$0.00 |
| 94760 |
|
12 |
12 |
$0.00 |
| 3080F |
|
14 |
12 |
$0.00 |
| 96127 |
|
18 |
18 |
$0.00 |