| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,086 |
45,089 |
$2.96M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,945 |
6,819 |
$523K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,414 |
4,195 |
$290K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,110 |
3,061 |
$234K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,846 |
2,626 |
$229K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,065 |
5,376 |
$218K |
| 92552 |
|
7,730 |
7,559 |
$216K |
| 90686 |
|
10,783 |
10,129 |
$122K |
| 99000 |
|
33,189 |
30,171 |
$106K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,577 |
1,249 |
$104K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
901 |
882 |
$73K |
| 94760 |
|
60,456 |
54,412 |
$54K |
| 90670 |
|
2,484 |
2,403 |
$46K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23,489 |
22,854 |
$42K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,349 |
1,307 |
$40K |
| 87428 |
|
1,226 |
1,180 |
$38K |
| 36415 |
Collection of venous blood by venipuncture |
14,123 |
13,052 |
$32K |
| 90656 |
|
2,255 |
2,247 |
$29K |
| 0002A |
|
776 |
754 |
$27K |
| 90677 |
|
512 |
488 |
$27K |
| D1120 |
Prophylaxis - child |
1,505 |
1,487 |
$25K |
| 99173 |
|
10,575 |
10,322 |
$25K |
| 90698 |
|
1,271 |
1,235 |
$22K |
| 0001A |
|
603 |
596 |
$22K |
| 90671 |
|
481 |
471 |
$21K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,992 |
1,607 |
$16K |
| D1206 |
Topical application of fluoride varnish |
1,546 |
1,527 |
$15K |
| D0120 |
Periodic oral evaluation - established patient |
957 |
951 |
$15K |
| 0072A |
|
363 |
361 |
$14K |
| 0071A |
|
343 |
340 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
916 |
902 |
$12K |
| 90832 |
Psychotherapy, 30 minutes with patient |
231 |
222 |
$12K |
| 90633 |
|
929 |
917 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
832 |
823 |
$12K |
| 90681 |
|
673 |
649 |
$12K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
319 |
314 |
$11K |
| 90697 |
|
573 |
554 |
$10K |
| 59430 |
|
38 |
37 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
7,660 |
7,265 |
$8K |
| 0012A |
|
227 |
225 |
$7K |
| 90480 |
|
548 |
525 |
$7K |
| 90651 |
|
164 |
157 |
$6K |
| 99215 |
Prolong outpt/office vis |
63 |
54 |
$6K |
| 91318 |
|
201 |
187 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
852 |
846 |
$4K |
| 99188 |
|
213 |
212 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
734 |
578 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
240 |
236 |
$3K |
| 91320 |
|
32 |
28 |
$3K |
| 99381 |
|
42 |
38 |
$3K |
| 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 |
125 |
106 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
25 |
25 |
$3K |
| D0274 |
Bitewings - four radiographic images |
326 |
322 |
$3K |
| 0011A |
|
136 |
136 |
$2K |
| D1110 |
Prophylaxis - adult |
72 |
72 |
$2K |
| 0004A |
|
55 |
53 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
28 |
28 |
$2K |
| 0081A |
|
46 |
46 |
$2K |
| 90744 |
|
180 |
171 |
$2K |
| 90716 |
|
53 |
53 |
$2K |
| 97802 |
|
190 |
123 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
25 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
322 |
316 |
$1K |
| 90734 |
|
29 |
26 |
$1K |
| 90707 |
|
53 |
53 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
49 |
49 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$992.28 |
| 90715 |
|
24 |
24 |
$860.27 |
| D0272 |
Bitewings - two radiographic images |
82 |
82 |
$806.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
104 |
96 |
$649.87 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
731 |
640 |
$530.40 |
| 90672 |
|
42 |
41 |
$493.52 |
| 0124A |
|
12 |
12 |
$480.00 |
| 0082A |
|
12 |
12 |
$480.00 |
| 0154A |
|
12 |
12 |
$480.00 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$431.92 |
| 90648 |
|
41 |
40 |
$417.40 |
| 82947 |
|
267 |
241 |
$347.11 |
| 90710 |
|
12 |
12 |
$331.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
16 |
12 |
$320.00 |
| 90461 |
|
326 |
278 |
$319.60 |
| D0140 |
Limited oral evaluation - problem focused |
50 |
48 |
$273.13 |
| 3008F |
|
2,784 |
2,593 |
$207.50 |
| 86580 |
|
26 |
25 |
$181.92 |
| 81025 |
|
14 |
14 |
$96.85 |
| 96127 |
|
14 |
14 |
$70.09 |
| 90473 |
|
83 |
79 |
$35.30 |
| 96160 |
|
42 |
40 |
$19.67 |
| 36416 |
|
448 |
406 |
$5.04 |
| 4004F |
|
129 |
129 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
173 |
173 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
79 |
73 |
$0.00 |
| 91308 |
|
69 |
68 |
$0.00 |
| 96161 |
|
77 |
74 |
$0.00 |
| D1351 |
Sealant - per tooth |
41 |
12 |
$0.00 |