| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31,649 |
25,929 |
$1.26M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,112 |
12,902 |
$880K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,731 |
2,692 |
$190K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,551 |
2,534 |
$184K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,455 |
2,380 |
$164K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,675 |
1,651 |
$118K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,506 |
2,324 |
$83K |
| 90715 |
|
3,368 |
3,325 |
$65K |
| 99408 |
|
2,774 |
2,552 |
$52K |
| 90698 |
|
1,893 |
1,851 |
$50K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,847 |
2,563 |
$47K |
| 90707 |
|
2,440 |
2,406 |
$45K |
| 90696 |
|
1,633 |
1,619 |
$41K |
| 90710 |
|
1,543 |
1,532 |
$40K |
| 83655 |
|
3,058 |
3,014 |
$31K |
| 90734 |
|
3,794 |
3,742 |
$22K |
| 90670 |
|
3,771 |
3,697 |
$21K |
| 90723 |
|
788 |
779 |
$21K |
| 86580 |
|
3,199 |
2,741 |
$21K |
| 90633 |
|
3,392 |
3,348 |
$21K |
| 90697 |
|
590 |
574 |
$19K |
| 90686 |
|
3,084 |
3,034 |
$18K |
| 81025 |
|
2,684 |
2,548 |
$18K |
| 83037 |
|
4,559 |
3,195 |
$18K |
| 99381 |
|
272 |
265 |
$17K |
| 90716 |
|
2,577 |
2,548 |
$16K |
| 90700 |
|
1,013 |
998 |
$16K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
405 |
394 |
$14K |
| 90651 |
|
1,883 |
1,853 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,314 |
3,690 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
153 |
153 |
$11K |
| 81003 |
|
5,544 |
3,962 |
$10K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
179 |
168 |
$10K |
| 90744 |
|
1,597 |
1,575 |
$9K |
| 85018 |
|
4,485 |
4,397 |
$9K |
| 90619 |
|
1,019 |
1,017 |
$8K |
| 90681 |
|
1,400 |
1,368 |
$8K |
| 99383 |
|
94 |
94 |
$7K |
| 98940 |
|
383 |
225 |
$7K |
| D1110 |
Prophylaxis - adult |
207 |
201 |
$6K |
| 90713 |
|
841 |
828 |
$6K |
| 99384 |
|
75 |
73 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
109 |
109 |
$4K |
| 90677 |
|
214 |
207 |
$4K |
| 90647 |
|
677 |
660 |
$4K |
| 90480 |
|
239 |
176 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
113 |
108 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
166 |
162 |
$2K |
| D0274 |
Bitewings - four radiographic images |
72 |
71 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
134 |
102 |
$1K |
| H0049 |
Alcohol and/or drug screening |
68 |
65 |
$926.69 |
| 82962 |
|
300 |
267 |
$625.29 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
354 |
148 |
$595.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
43 |
43 |
$569.32 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
43 |
43 |
$561.66 |
| 86592 |
|
189 |
169 |
$480.81 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
16 |
14 |
$449.12 |
| 99385 |
|
14 |
14 |
$440.48 |
| 83986 |
|
146 |
128 |
$396.60 |
| 90685 |
|
74 |
74 |
$381.42 |
| 80305 |
|
27 |
25 |
$272.16 |
| 87210 |
|
68 |
48 |
$251.10 |
| 96160 |
|
933 |
761 |
$163.71 |
| 86703 |
|
33 |
26 |
$142.48 |
| D0220 |
Intraoral - periapical first radiographic image |
19 |
18 |
$141.30 |
| D0230 |
Intraoral - periapical each additional radiographic image |
17 |
17 |
$108.75 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
51 |
36 |
$108.15 |
| 90656 |
|
12 |
12 |
$96.84 |
| 86803 |
|
20 |
15 |
$91.28 |
| 90648 |
|
12 |
12 |
$63.24 |
| 96127 |
|
106 |
82 |
$31.28 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
112 |
91 |
$0.00 |