| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54,655 |
49,161 |
$8.30M |
| D0999 |
Unspecified diagnostic procedure, by report |
20,568 |
17,915 |
$4.97M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,399 |
10,468 |
$1.07M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,333 |
4,155 |
$699K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
3,141 |
1,310 |
$477K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,604 |
1,573 |
$262K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,225 |
1,168 |
$183K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,938 |
7,747 |
$143K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
821 |
786 |
$128K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
571 |
560 |
$105K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
370 |
360 |
$63K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
446 |
433 |
$62K |
| D1110 |
Prophylaxis - adult |
2,148 |
2,111 |
$58K |
| D0120 |
Periodic oral evaluation - established patient |
3,151 |
3,080 |
$44K |
| 90686 |
|
1,698 |
1,649 |
$39K |
| D0330 |
Panoramic radiographic image |
1,341 |
1,300 |
$35K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
192 |
190 |
$27K |
| D0274 |
Bitewings - four radiographic images |
1,379 |
1,335 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,880 |
2,841 |
$27K |
| H0031 |
Mental health assessment, by non-physician |
205 |
133 |
$26K |
| D0220 |
Intraoral - periapical first radiographic image |
3,547 |
3,428 |
$26K |
| D0190 |
|
2,272 |
2,241 |
$24K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,089 |
1,060 |
$24K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
329 |
246 |
$23K |
| D0145 |
Oral evaluation for a patient under three years of age |
889 |
867 |
$22K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
155 |
150 |
$21K |
| D1351 |
Sealant - per tooth |
1,501 |
521 |
$21K |
| 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 |
934 |
816 |
$18K |
| D1120 |
Prophylaxis - child |
764 |
738 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
93 |
90 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
64 |
62 |
$9K |
| D7140 |
Extraction, erupted tooth or exposed root |
262 |
150 |
$8K |
| 90461 |
|
1,066 |
1,045 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,499 |
2,432 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
192 |
189 |
$7K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
268 |
216 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
126 |
90 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
28 |
27 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
23 |
14 |
$3K |
| 90682 |
|
34 |
33 |
$2K |
| D1206 |
Topical application of fluoride varnish |
7,387 |
7,136 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
157 |
151 |
$2K |
| 90670 |
|
55 |
51 |
$1K |
| 99000 |
|
1,545 |
1,506 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
5,211 |
5,027 |
$586.10 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
4,998 |
3,800 |
$518.31 |
| D0270 |
|
26 |
26 |
$457.00 |
| 81003 |
|
2,055 |
1,836 |
$193.70 |
| 85018 |
|
128 |
127 |
$4.01 |
| 36416 |
|
157 |
152 |
$3.16 |
| 92551 |
|
288 |
253 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
42 |
42 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
17 |
17 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
50 |
49 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
29 |
29 |
$0.00 |
| 90688 |
|
16 |
16 |
$0.00 |
| 99173 |
|
746 |
710 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
330 |
322 |
$0.00 |
| 81025 |
|
580 |
562 |
$0.00 |
| 90662 |
|
12 |
12 |
$0.00 |
| D4910 |
|
12 |
12 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
38 |
12 |
$0.00 |