| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
41,553 |
32,723 |
$823K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,835 |
7,009 |
$235K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,355 |
2,861 |
$190K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,059 |
2,827 |
$184K |
| D1120 |
Prophylaxis - child |
3,683 |
3,659 |
$164K |
| H1000 |
Prenatal care, at-risk assessment |
6,007 |
3,296 |
$134K |
| D1110 |
Prophylaxis - adult |
1,860 |
1,846 |
$128K |
| 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 |
20,337 |
7,782 |
$73K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
15,094 |
5,702 |
$73K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
482 |
318 |
$70K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
926 |
813 |
$59K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
830 |
670 |
$52K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
972 |
964 |
$51K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
888 |
676 |
$41K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
504 |
420 |
$29K |
| D1206 |
Topical application of fluoride varnish |
4,561 |
4,513 |
$21K |
| D1351 |
Sealant - per tooth |
2,287 |
707 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,363 |
1,057 |
$18K |
| D0603 |
|
3,199 |
3,183 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
418 |
325 |
$17K |
| D7140 |
Extraction, erupted tooth or exposed root |
509 |
325 |
$16K |
| D0140 |
Limited oral evaluation - problem focused |
1,143 |
1,116 |
$16K |
| D0120 |
Periodic oral evaluation - established patient |
4,566 |
4,545 |
$16K |
| 99381 |
|
357 |
227 |
$15K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,533 |
4,178 |
$13K |
| D0330 |
Panoramic radiographic image |
451 |
449 |
$12K |
| D0274 |
Bitewings - four radiographic images |
1,939 |
1,930 |
$11K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,322 |
1,310 |
$11K |
| 99307 |
|
4,691 |
2,379 |
$10K |
| 0002A |
|
707 |
471 |
$9K |
| 0001A |
|
671 |
453 |
$8K |
| 90791 |
Psychiatric diagnostic evaluation |
151 |
98 |
$8K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
947 |
904 |
$7K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
642 |
307 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
165 |
144 |
$5K |
| 90837 |
Psychotherapy, 53 minutes with patient |
99 |
57 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
5,654 |
5,460 |
$5K |
| 99490 |
Ccm add 20min |
1,069 |
711 |
$4K |
| D0272 |
Bitewings - two radiographic images |
2,855 |
2,843 |
$4K |
| D1354 |
|
467 |
75 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
140 |
82 |
$3K |
| D1330 |
|
5,756 |
5,720 |
$3K |
| D9999 |
Unspecified adjunctive procedure, by report |
136 |
136 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
35 |
32 |
$3K |
| 99305 |
|
228 |
177 |
$2K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
497 |
363 |
$2K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
744 |
356 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
135 |
129 |
$2K |
| D1999 |
|
40 |
40 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
14 |
12 |
$2K |
| 99401 |
|
4,159 |
2,796 |
$2K |
| D0999 |
Unspecified diagnostic procedure, by report |
72 |
72 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
445 |
398 |
$1K |
| D0240 |
|
156 |
117 |
$1K |
| 81003 |
|
6,689 |
3,807 |
$895.87 |
| 99306 |
Prolong nursin fac eval 15m |
21 |
13 |
$780.48 |
| 85018 |
|
4,932 |
4,258 |
$774.39 |
| 59430 |
|
62 |
29 |
$671.91 |
| D0602 |
|
30 |
30 |
$411.00 |
| 0031A |
|
28 |
12 |
$240.00 |
| 82962 |
|
1,449 |
1,065 |
$189.94 |
| 0003A |
|
95 |
74 |
$160.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
65 |
63 |
$142.88 |
| 99441 |
|
37 |
25 |
$76.55 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
26 |
$59.58 |
| 0011A |
|
24 |
14 |
$50.82 |
| 0012A |
|
28 |
18 |
$28.39 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
175 |
82 |
$15.54 |
| 99406 |
|
132 |
85 |
$14.00 |
| G0009 |
Administration of pneumococcal vaccine |
71 |
70 |
$11.89 |
| 96127 |
|
225 |
179 |
$11.02 |
| 81025 |
|
46 |
31 |
$10.00 |
| 82043 |
|
51 |
44 |
$5.84 |
| 97802 |
|
3,832 |
3,005 |
$5.45 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$2.00 |
| 92558 |
|
1,722 |
1,348 |
$1.14 |
| 99173 |
|
2,073 |
1,742 |
$0.11 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
1,078 |
866 |
$0.03 |
| G8482 |
Influenza immunization administered or previously received |
1,694 |
1,427 |
$0.02 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
902 |
700 |
$0.01 |
| 1036F |
|
726 |
464 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,102 |
767 |
$0.00 |
| 91301 |
|
46 |
27 |
$0.00 |
| 1170F |
|
83 |
78 |
$0.00 |
| G8542 |
Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required |
463 |
318 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
107 |
90 |
$0.00 |
| 3075F |
|
41 |
28 |
$0.00 |
| 3074F |
|
81 |
67 |
$0.00 |
| 90686 |
|
19 |
19 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
17 |
14 |
$0.00 |
| 91303 |
|
28 |
12 |
$0.00 |
| 90674 |
|
66 |
52 |
$0.00 |
| D0601 |
|
25 |
25 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
889 |
755 |
$0.00 |
| 99334 |
|
60 |
37 |
$0.00 |
| 1159F |
|
83 |
78 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
76 |
73 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
331 |
208 |
$0.00 |
| D0460 |
|
12 |
12 |
$0.00 |
| 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 |
199 |
143 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,563 |
1,080 |
$0.00 |
| 3078F |
|
196 |
135 |
$0.00 |
| 91300 |
|
1,218 |
700 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
238 |
165 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
843 |
616 |
$0.00 |
| 1160F |
|
83 |
78 |
$0.00 |
| 4004F |
|
230 |
151 |
$0.00 |
| G8730 |
Pain assessment documented as positive using a standardized tool and a follow-up plan is documented |
53 |
44 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
14 |
12 |
$0.00 |
| G8731 |
Pain assessment using a standardized tool is documented as negative, no follow-up plan required |
57 |
54 |
$0.00 |
| G8539 |
Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment |
18 |
14 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
25 |
19 |
$0.00 |