| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,533 |
8,124 |
$210K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
669 |
615 |
$58K |
| H1000 |
Prenatal care, at-risk assessment |
1,059 |
778 |
$51K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
514 |
483 |
$37K |
| 99336 |
|
1,064 |
926 |
$31K |
| 99349 |
|
485 |
279 |
$26K |
| T1015 |
Clinic visit/encounter, all-inclusive |
800 |
568 |
$25K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,107 |
936 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,070 |
857 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
239 |
220 |
$18K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
430 |
274 |
$16K |
| D0120 |
Periodic oral evaluation - established patient |
2,599 |
1,914 |
$16K |
| D1110 |
Prophylaxis - adult |
1,099 |
962 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,452 |
1,122 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,590 |
2,481 |
$5K |
| D0210 |
Intraoral - complete series of radiographic images |
725 |
691 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
51 |
51 |
$5K |
| D1330 |
|
1,835 |
1,467 |
$5K |
| H2000 |
Comprehensive multidisciplinary evaluation |
33 |
32 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
216 |
150 |
$4K |
| D0274 |
Bitewings - four radiographic images |
685 |
579 |
$3K |
| D1120 |
Prophylaxis - child |
573 |
488 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,723 |
1,254 |
$3K |
| D1206 |
Topical application of fluoride varnish |
900 |
742 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,053 |
1,002 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
67 |
66 |
$2K |
| D1351 |
Sealant - per tooth |
232 |
71 |
$2K |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
91 |
53 |
$2K |
| 99201 |
|
105 |
98 |
$2K |
| 99337 |
|
31 |
31 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
279 |
257 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
106 |
65 |
$2K |
| D0190 |
|
134 |
133 |
$2K |
| 99350 |
Prolong home eval add 15m |
17 |
12 |
$2K |
| D9995 |
|
219 |
216 |
$1K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
60 |
41 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
2,373 |
1,832 |
$1K |
| D0603 |
|
135 |
101 |
$1K |
| 3008F |
|
6,981 |
5,400 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
42 |
$849.94 |
| 90686 |
|
1,029 |
1,012 |
$818.39 |
| 2001F |
|
6,059 |
4,069 |
$687.71 |
| 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 |
325 |
188 |
$494.87 |
| 36415 |
Collection of venous blood by venipuncture |
171 |
138 |
$490.35 |
| D0272 |
Bitewings - two radiographic images |
336 |
303 |
$478.85 |
| 99334 |
|
55 |
50 |
$423.62 |
| 91301 |
|
16 |
15 |
$291.05 |
| D9310 |
|
12 |
12 |
$267.50 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
54 |
54 |
$260.00 |
| 80053 |
Comprehensive metabolic panel |
39 |
21 |
$226.98 |
| D0240 |
|
263 |
190 |
$196.49 |
| 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 |
48 |
32 |
$182.70 |
| 1000F |
|
2,183 |
1,983 |
$181.63 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
161 |
97 |
$154.35 |
| 99177 |
|
102 |
100 |
$120.00 |
| 3078F |
|
2,210 |
1,535 |
$114.64 |
| 92551 |
|
136 |
128 |
$91.37 |
| 1036F |
|
382 |
354 |
$85.17 |
| G0179 |
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
150 |
145 |
$71.57 |
| 92015 |
Determination of refractive state |
116 |
114 |
$70.00 |
| 3351F |
|
986 |
908 |
$66.17 |
| 0012A |
|
15 |
14 |
$65.22 |
| V2020 |
Frames, purchases |
53 |
53 |
$60.00 |
| 81025 |
|
28 |
28 |
$50.48 |
| 4004F |
|
296 |
267 |
$25.22 |
| 92558 |
|
132 |
131 |
$18.69 |
| D4346 |
|
164 |
123 |
$15.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
40 |
40 |
$12.61 |
| 3352F |
|
309 |
273 |
$12.61 |
| 81002 |
|
38 |
13 |
$4.18 |
| 99173 |
|
200 |
191 |
$3.14 |
| 3077F |
|
50 |
40 |
$0.00 |
| 0502F |
|
83 |
62 |
$0.00 |
| 2022F |
|
58 |
57 |
$0.00 |
| D0330 |
Panoramic radiographic image |
363 |
299 |
$0.00 |
| 3293F |
|
118 |
83 |
$0.00 |
| 90670 |
|
55 |
55 |
$0.00 |
| 1160F |
|
1,380 |
694 |
$0.00 |
| 90633 |
|
48 |
39 |
$0.00 |
| 1159F |
|
1,379 |
693 |
$0.00 |
| 2028F |
|
244 |
226 |
$0.00 |
| 1090F |
|
18 |
18 |
$0.00 |
| 1033F |
|
21 |
21 |
$0.00 |
| 3725F |
|
119 |
118 |
$0.00 |
| 99408 |
|
14 |
12 |
$0.00 |
| 3288F |
|
14 |
14 |
$0.00 |
| 2000F |
|
3,143 |
2,104 |
$0.00 |
| 1220F |
|
1,488 |
1,123 |
$0.00 |
| 3074F |
|
2,106 |
1,462 |
$0.00 |
| 1126F |
|
1,088 |
849 |
$0.00 |
| 1157F |
|
355 |
139 |
$0.00 |
| 90651 |
|
56 |
42 |
$0.00 |
| 3044F |
|
49 |
47 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
218 |
142 |
$0.00 |
| 3079F |
|
285 |
156 |
$0.00 |
| 1125F |
|
102 |
97 |
$0.00 |
| 3048F |
|
26 |
26 |
$0.00 |
| 90698 |
|
28 |
28 |
$0.00 |
| 1170F |
|
14 |
14 |
$0.00 |
| 3292F |
|
119 |
83 |
$0.00 |
| D1310 |
|
13 |
13 |
$0.00 |
| 1101F |
|
21 |
21 |
$0.00 |
| 4010F |
|
35 |
18 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |