| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,335 |
9,599 |
$2.15M |
| D0999 |
Unspecified diagnostic procedure, by report |
3,385 |
3,006 |
$1.12M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,975 |
1,665 |
$368K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,254 |
1,126 |
$241K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
963 |
589 |
$177K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
501 |
410 |
$87K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
299 |
271 |
$56K |
| 90837 |
Psychotherapy, 53 minutes with patient |
250 |
130 |
$45K |
| 90834 |
Psychotherapy, 45 minutes with patient |
284 |
143 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,529 |
2,309 |
$36K |
| 99215 |
Prolong outpt/office vis |
145 |
129 |
$28K |
| 90832 |
Psychotherapy, 30 minutes with patient |
119 |
39 |
$25K |
| 99205 |
Prolong outpt/office vis |
85 |
85 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
69 |
67 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
66 |
61 |
$12K |
| 90688 |
|
1,039 |
991 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
42 |
38 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
237 |
234 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
25 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
912 |
795 |
$6K |
| 96127 |
|
1,412 |
1,220 |
$5K |
| 92551 |
|
948 |
841 |
$5K |
| D0190 |
|
95 |
94 |
$4K |
| H0023 |
Behavioral health outreach service (planned approach to reach a targeted population) |
17 |
13 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
114 |
107 |
$4K |
| 99385 |
|
33 |
17 |
$3K |
| D1110 |
Prophylaxis - adult |
80 |
79 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
14 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
75 |
73 |
$2K |
| 1031F |
|
431 |
406 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
226 |
219 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
199 |
193 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
620 |
590 |
$1K |
| D0180 |
|
24 |
24 |
$990.00 |
| D1120 |
Prophylaxis - child |
15 |
13 |
$979.00 |
| 3008F |
|
250 |
238 |
$964.38 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
298 |
279 |
$728.28 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
82 |
56 |
$598.54 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
327 |
285 |
$500.00 |
| H0049 |
Alcohol and/or drug screening |
755 |
726 |
$447.80 |
| 90648 |
|
15 |
14 |
$267.92 |
| 3074F |
|
98 |
90 |
$249.19 |
| 3078F |
|
69 |
64 |
$249.19 |
| D0230 |
Intraoral - periapical each additional radiographic image |
29 |
27 |
$228.00 |
| 90651 |
|
13 |
13 |
$225.90 |
| S9470 |
Nutritional counseling, dietitian visit |
1,898 |
1,724 |
$225.90 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
137 |
129 |
$223.90 |
| 90687 |
|
44 |
43 |
$221.69 |
| D1206 |
Topical application of fluoride varnish |
54 |
52 |
$150.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
99 |
91 |
$15.70 |
| 99174 |
|
182 |
153 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
246 |
223 |
$0.00 |
| 3351F |
|
136 |
132 |
$0.00 |
| 90677 |
|
69 |
42 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 90656 |
|
43 |
31 |
$0.00 |
| 90680 |
|
55 |
36 |
$0.00 |
| 3079F |
|
45 |
43 |
$0.00 |
| 90619 |
|
14 |
14 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 99173 |
|
803 |
719 |
$0.00 |
| 91300 |
|
13 |
12 |
$0.00 |
| 96160 |
|
63 |
58 |
$0.00 |
| 99177 |
|
153 |
129 |
$0.00 |
| 90461 |
|
545 |
477 |
$0.00 |
| D0330 |
Panoramic radiographic image |
39 |
39 |
$0.00 |
| 99401 |
|
85 |
80 |
$0.00 |
| G8780 |
Counseling for diet and physical activity performed |
111 |
109 |
$0.00 |
| 90670 |
|
77 |
77 |
$0.00 |
| 90633 |
|
15 |
15 |
$0.00 |
| 3077F |
|
14 |
14 |
$0.00 |
| 99188 |
|
27 |
27 |
$0.00 |
| 90715 |
|
22 |
14 |
$0.00 |