| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,081 |
31,260 |
$1.15M |
| 90834 |
Psychotherapy, 45 minutes with patient |
10,284 |
6,411 |
$453K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,498 |
7,519 |
$392K |
| D0120 |
Periodic oral evaluation - established patient |
13,336 |
11,275 |
$254K |
| D1110 |
Prophylaxis - adult |
6,302 |
5,376 |
$241K |
| D1120 |
Prophylaxis - child |
10,391 |
8,699 |
$231K |
| D1206 |
Topical application of fluoride varnish |
13,473 |
11,249 |
$230K |
| D0330 |
Panoramic radiographic image |
3,368 |
2,802 |
$167K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,306 |
4,399 |
$166K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,962 |
5,792 |
$138K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,638 |
803 |
$118K |
| D0274 |
Bitewings - four radiographic images |
5,173 |
4,230 |
$92K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,277 |
811 |
$86K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,332 |
808 |
$85K |
| 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 |
5,888 |
4,612 |
$84K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,718 |
1,860 |
$71K |
| 99442 |
|
3,388 |
2,999 |
$69K |
| 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 |
2,584 |
2,499 |
$67K |
| D0140 |
Limited oral evaluation - problem focused |
2,957 |
2,599 |
$66K |
| 90791 |
Psychiatric diagnostic evaluation |
743 |
604 |
$56K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
461 |
441 |
$26K |
| D0220 |
Intraoral - periapical first radiographic image |
4,768 |
4,049 |
$25K |
| 99215 |
Prolong outpt/office vis |
314 |
295 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
402 |
390 |
$22K |
| D0210 |
Intraoral - complete series of radiographic images |
645 |
410 |
$22K |
| D0272 |
Bitewings - two radiographic images |
1,781 |
1,411 |
$20K |
| D1351 |
Sealant - per tooth |
423 |
113 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
211 |
209 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
123 |
112 |
$6K |
| 90832 |
Psychotherapy, 30 minutes with patient |
143 |
125 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
137 |
98 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
68 |
66 |
$3K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
130 |
98 |
$3K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
129 |
88 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
129 |
116 |
$2K |
| 99406 |
|
303 |
235 |
$2K |
| 92587 |
|
95 |
93 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
65 |
62 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
357 |
109 |
$1K |
| 99441 |
|
129 |
120 |
$1K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
16 |
12 |
$907.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
123 |
94 |
$898.08 |
| 99385 |
|
12 |
12 |
$895.20 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
13 |
13 |
$849.02 |
| 90674 |
|
52 |
48 |
$816.00 |
| D2140 |
|
19 |
12 |
$798.00 |
| D9995 |
|
141 |
138 |
$656.88 |
| 99422 |
|
29 |
25 |
$649.66 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
46 |
45 |
$632.02 |
| 81002 |
|
280 |
211 |
$488.15 |
| 81025 |
|
79 |
66 |
$468.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
33 |
$414.91 |
| D0270 |
|
89 |
81 |
$382.00 |
| 96127 |
|
100 |
92 |
$369.72 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
69 |
69 |
$330.48 |
| 90715 |
|
73 |
71 |
$313.39 |
| 90686 |
|
167 |
159 |
$222.88 |
| 90734 |
|
115 |
115 |
$10.19 |
| 90670 |
|
146 |
132 |
$0.31 |
| 90707 |
|
66 |
66 |
$0.22 |
| 90716 |
|
56 |
56 |
$0.19 |
| 90700 |
|
54 |
54 |
$0.18 |
| 90651 |
|
92 |
92 |
$0.15 |
| 90633 |
|
55 |
54 |
$0.13 |
| 90698 |
|
34 |
28 |
$0.09 |
| 90744 |
|
12 |
12 |
$0.05 |
| 90713 |
|
13 |
13 |
$0.05 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,105 |
895 |
$0.00 |
| 3074F |
|
336 |
259 |
$0.00 |
| D0602 |
|
186 |
149 |
$0.00 |
| 3079F |
|
179 |
151 |
$0.00 |
| 1036F |
|
57 |
56 |
$0.00 |
| D0603 |
|
264 |
201 |
$0.00 |
| 3075F |
|
17 |
14 |
$0.00 |
| 1000F |
|
12 |
12 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
15 |
15 |
$0.00 |
| 90694 |
|
14 |
14 |
$0.00 |
| 99173 |
|
513 |
457 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
3,634 |
2,594 |
$0.00 |
| 96160 |
|
41 |
41 |
$0.00 |
| 3077F |
|
63 |
50 |
$0.00 |
| 3078F |
|
265 |
192 |
$0.00 |
| 4004F |
|
53 |
53 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
12 |
12 |
$0.00 |