| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,408 |
13,662 |
$3.01M |
| D0999 |
Unspecified diagnostic procedure, by report |
8,122 |
6,338 |
$2.85M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,773 |
5,248 |
$1.08M |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,575 |
2,485 |
$93K |
| 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 |
3,123 |
2,709 |
$68K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
198 |
151 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
85 |
79 |
$22K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,188 |
548 |
$17K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
895 |
751 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
1,245 |
1,146 |
$13K |
| 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 |
1,239 |
771 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
30 |
$8K |
| D0120 |
Periodic oral evaluation - established patient |
609 |
545 |
$7K |
| 99000 |
|
1,874 |
1,464 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
1,493 |
1,355 |
$5K |
| D1110 |
Prophylaxis - adult |
225 |
196 |
$5K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
162 |
78 |
$5K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
165 |
80 |
$5K |
| 99215 |
Prolong outpt/office vis |
25 |
25 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
12 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
105 |
74 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
695 |
642 |
$3K |
| D1206 |
Topical application of fluoride varnish |
196 |
161 |
$3K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
101 |
59 |
$2K |
| D1354 |
|
200 |
36 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,087 |
1,056 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
214 |
209 |
$1K |
| D1120 |
Prophylaxis - child |
15 |
15 |
$744.00 |
| D0274 |
Bitewings - four radiographic images |
81 |
81 |
$738.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
354 |
346 |
$625.90 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
49 |
32 |
$515.48 |
| D0270 |
|
192 |
188 |
$312.00 |
| 91322 |
|
17 |
17 |
$70.00 |
| 81002 |
|
539 |
491 |
$0.00 |
| 81025 |
|
30 |
27 |
$0.00 |
| 99173 |
|
54 |
51 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
67 |
41 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
266 |
259 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
31 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
15 |
15 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
28 |
24 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 99499 |
|
15 |
15 |
$0.00 |
| 90686 |
|
672 |
659 |
$0.00 |
| 90656 |
|
61 |
59 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
53 |
52 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
14 |
14 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
27 |
25 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
19 |
18 |
$0.00 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
12 |
12 |
$0.00 |
| 93000 |
|
12 |
12 |
$0.00 |