| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45,461 |
39,921 |
$1.56M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,581 |
14,895 |
$786K |
| 90834 |
Psychotherapy, 45 minutes with patient |
9,588 |
6,284 |
$436K |
| 90832 |
Psychotherapy, 30 minutes with patient |
8,147 |
5,047 |
$300K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,643 |
1,971 |
$163K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,555 |
5,419 |
$161K |
| D0210 |
Intraoral - complete series of radiographic images |
2,009 |
1,922 |
$122K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,700 |
989 |
$113K |
| D1110 |
Prophylaxis - adult |
2,773 |
2,679 |
$109K |
| 90791 |
Psychiatric diagnostic evaluation |
1,276 |
1,166 |
$109K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,363 |
1,318 |
$100K |
| 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 |
6,411 |
5,028 |
$87K |
| 99441 |
|
7,772 |
6,422 |
$85K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,193 |
1,034 |
$79K |
| D0330 |
Panoramic radiographic image |
1,423 |
1,393 |
$65K |
| D1120 |
Prophylaxis - child |
1,680 |
1,623 |
$40K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,653 |
1,166 |
$39K |
| D0120 |
Periodic oral evaluation - established patient |
1,418 |
1,347 |
$32K |
| D0274 |
Bitewings - four radiographic images |
1,580 |
1,521 |
$31K |
| 90837 |
Psychotherapy, 53 minutes with patient |
415 |
284 |
$28K |
| D1206 |
Topical application of fluoride varnish |
1,226 |
1,188 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
357 |
327 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
335 |
329 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
624 |
593 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
606 |
567 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
221 |
185 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
192 |
179 |
$10K |
| 0011A |
|
315 |
252 |
$10K |
| Q3014 |
Telehealth originating site facility fee |
391 |
370 |
$7K |
| D2330 |
|
99 |
72 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
351 |
343 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
183 |
180 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
497 |
397 |
$4K |
| 90688 |
|
257 |
242 |
$3K |
| D1351 |
Sealant - per tooth |
92 |
27 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
582 |
538 |
$3K |
| D0272 |
Bitewings - two radiographic images |
288 |
279 |
$3K |
| 0064A |
|
58 |
56 |
$3K |
| 99442 |
|
130 |
106 |
$2K |
| 97803 |
|
42 |
40 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
353 |
347 |
$2K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
39 |
31 |
$2K |
| 0012A |
|
54 |
42 |
$2K |
| D2331 |
|
20 |
14 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
122 |
109 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
271 |
196 |
$1K |
| T2003 |
Non-emergency transportation; encounter/trip |
98 |
77 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
30 |
29 |
$936.15 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
32 |
31 |
$359.11 |
| 90658 |
|
31 |
31 |
$273.78 |
| 81003 |
|
153 |
148 |
$245.13 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
47 |
32 |
$124.11 |
| 90649 |
|
36 |
31 |
$54.25 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
149 |
83 |
$33.08 |
| 90686 |
|
95 |
78 |
$29.03 |
| 91301 |
|
364 |
294 |
$2.70 |
| 91306 |
|
27 |
26 |
$0.01 |
| 91300 |
|
27 |
25 |
$0.01 |
| 3074F |
|
50 |
49 |
$0.00 |
| D0603 |
|
38 |
34 |
$0.00 |
| 90619 |
|
16 |
15 |
$0.00 |
| D1320 |
|
34 |
34 |
$0.00 |
| 1000F |
|
34 |
34 |
$0.00 |
| 3079F |
|
14 |
12 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
384 |
250 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
16 |
14 |
$0.00 |
| 90715 |
|
21 |
18 |
$0.00 |
| 1160F |
|
299 |
257 |
$0.00 |
| 90734 |
|
43 |
38 |
$0.00 |