| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,979 |
7,827 |
$206K |
| H1000 |
Prenatal care, at-risk assessment |
3,741 |
1,994 |
$106K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,235 |
1,130 |
$74K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,033 |
983 |
$61K |
| 90834 |
Psychotherapy, 45 minutes with patient |
884 |
562 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,393 |
892 |
$31K |
| 90832 |
Psychotherapy, 30 minutes with patient |
616 |
295 |
$27K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
586 |
442 |
$25K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,600 |
1,079 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
332 |
328 |
$21K |
| D0330 |
Panoramic radiographic image |
584 |
574 |
$18K |
| D1110 |
Prophylaxis - adult |
954 |
934 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
247 |
246 |
$16K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
418 |
334 |
$14K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
206 |
185 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,837 |
1,649 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
786 |
723 |
$5K |
| D1120 |
Prophylaxis - child |
201 |
198 |
$5K |
| D1330 |
|
993 |
960 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
607 |
463 |
$5K |
| D1206 |
Topical application of fluoride varnish |
906 |
875 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
399 |
220 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
858 |
775 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
48 |
38 |
$3K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,063 |
200 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
718 |
674 |
$2K |
| 90670 |
|
353 |
325 |
$1K |
| D0274 |
Bitewings - four radiographic images |
720 |
711 |
$1K |
| 59430 |
|
97 |
52 |
$1K |
| 99401 |
|
335 |
150 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
2,371 |
1,818 |
$1K |
| 90686 |
|
286 |
278 |
$1K |
| 90671 |
|
73 |
69 |
$989.60 |
| D0140 |
Limited oral evaluation - problem focused |
121 |
120 |
$944.70 |
| D0191 |
|
196 |
192 |
$819.20 |
| D0220 |
Intraoral - periapical first radiographic image |
1,577 |
1,445 |
$739.80 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
32 |
13 |
$706.78 |
| 84443 |
Thyroid stimulating hormone (TSH) |
123 |
108 |
$618.09 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
234 |
220 |
$611.92 |
| 3074F |
|
9,423 |
6,760 |
$548.86 |
| 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 |
147 |
97 |
$547.30 |
| 83655 |
|
96 |
94 |
$515.35 |
| 90677 |
|
30 |
29 |
$506.42 |
| 81025 |
|
399 |
248 |
$496.01 |
| 90674 |
|
138 |
104 |
$393.03 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
181 |
160 |
$369.25 |
| 81002 |
|
987 |
602 |
$358.70 |
| 91301 |
|
34 |
25 |
$301.18 |
| 90647 |
|
119 |
109 |
$296.00 |
| 80053 |
Comprehensive metabolic panel |
194 |
169 |
$282.84 |
| 92558 |
|
38 |
38 |
$244.17 |
| 82962 |
|
261 |
213 |
$227.08 |
| 0012A |
|
18 |
14 |
$202.59 |
| 90723 |
|
68 |
66 |
$175.20 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
16 |
15 |
$160.75 |
| 3075F |
|
554 |
434 |
$150.00 |
| 90633 |
|
115 |
107 |
$128.00 |
| 80061 |
Lipid panel |
61 |
42 |
$118.46 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
28 |
$111.33 |
| 90681 |
|
66 |
62 |
$103.20 |
| D0272 |
Bitewings - two radiographic images |
30 |
30 |
$91.44 |
| 90710 |
|
41 |
39 |
$80.00 |
| 85018 |
|
220 |
209 |
$75.83 |
| 90474 |
|
18 |
16 |
$70.00 |
| 83721 |
|
29 |
27 |
$68.81 |
| 90734 |
|
15 |
14 |
$64.00 |
| 90651 |
|
18 |
17 |
$64.00 |
| 1160F |
|
10,793 |
7,753 |
$39.68 |
| 3078F |
|
7,827 |
5,462 |
$36.75 |
| 82570 |
|
14 |
13 |
$15.07 |
| D0603 |
|
777 |
716 |
$14.00 |
| 1159F |
|
10,633 |
7,648 |
$10.00 |
| 2001F |
|
18,177 |
13,109 |
$9.77 |
| 3008F |
|
11,873 |
8,762 |
$5.83 |
| 82043 |
|
15 |
14 |
$4.80 |
| D0601 |
|
86 |
85 |
$3.00 |
| 36416 |
|
114 |
100 |
$3.00 |
| 81003 |
|
111 |
58 |
$1.82 |
| 3210F |
|
80 |
67 |
$0.00 |
| 99173 |
|
435 |
423 |
$0.00 |
| 0502F |
|
126 |
49 |
$0.00 |
| 3077F |
|
193 |
148 |
$0.00 |
| 2028F |
|
456 |
349 |
$0.00 |
| 99177 |
|
14 |
14 |
$0.00 |
| 90461 |
|
329 |
296 |
$0.00 |
| 4035F |
|
18 |
18 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 2010F |
|
3,972 |
3,058 |
$0.00 |
| 2000F |
|
13,601 |
9,285 |
$0.00 |
| 1126F |
|
4,103 |
2,517 |
$0.00 |
| 1000F |
|
9,423 |
6,918 |
$0.00 |
| D4999 |
|
182 |
179 |
$0.00 |
| 1036F |
|
1,083 |
786 |
$0.00 |
| 3044F |
|
1,218 |
993 |
$0.00 |
| 1157F |
|
468 |
202 |
$0.00 |
| 4000F |
|
3,286 |
2,537 |
$0.00 |
| 1220F |
|
3,769 |
2,869 |
$0.00 |
| 4060F |
|
623 |
150 |
$0.00 |
| 3079F |
|
2,624 |
1,764 |
$0.00 |
| 4037F |
|
108 |
108 |
$0.00 |
| 92551 |
|
132 |
127 |
$0.00 |
| 1055F |
|
382 |
371 |
$0.00 |
| 3048F |
|
30 |
28 |
$0.00 |
| 3351F |
|
62 |
60 |
$0.00 |
| 4010F |
|
33 |
19 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$0.00 |
| 99000 |
|
105 |
77 |
$0.00 |
| 3080F |
|
31 |
27 |
$0.00 |
| 1125F |
|
103 |
95 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
30 |
20 |
$0.00 |
| 90697 |
|
14 |
12 |
$0.00 |