| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,238 |
11,925 |
$1.63M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,128 |
1,946 |
$291K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,171 |
1,541 |
$208K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,843 |
1,382 |
$186K |
| 99442 |
|
1,369 |
1,250 |
$152K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,052 |
863 |
$130K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,411 |
872 |
$119K |
| D1110 |
Prophylaxis - adult |
3,300 |
1,459 |
$115K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
699 |
570 |
$75K |
| D0120 |
Periodic oral evaluation - established patient |
1,821 |
1,509 |
$37K |
| 99441 |
|
260 |
255 |
$29K |
| D0140 |
Limited oral evaluation - problem focused |
789 |
366 |
$28K |
| 99215 |
Prolong outpt/office vis |
375 |
125 |
$20K |
| 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 |
337 |
157 |
$18K |
| D1120 |
Prophylaxis - child |
517 |
218 |
$15K |
| D0330 |
Panoramic radiographic image |
624 |
468 |
$15K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
122 |
88 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
446 |
293 |
$11K |
| D0274 |
Bitewings - four radiographic images |
683 |
647 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
86 |
56 |
$9K |
| 97014 |
|
91 |
24 |
$9K |
| 92002 |
|
63 |
63 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
569 |
566 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
54 |
47 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
400 |
396 |
$3K |
| D4355 |
|
165 |
38 |
$3K |
| 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 |
12 |
12 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
68 |
49 |
$2K |
| 92551 |
|
205 |
205 |
$735.75 |
| D0272 |
Bitewings - two radiographic images |
42 |
42 |
$356.46 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
61 |
61 |
$351.62 |
| 92502 |
|
62 |
60 |
$254.94 |
| 90682 |
|
16 |
16 |
$222.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
76 |
75 |
$220.67 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$121.86 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
31 |
28 |
$45.10 |
| 99173 |
|
190 |
190 |
$3.66 |
| 82962 |
|
16 |
14 |
$1.70 |
| 99080 |
|
5,997 |
2,142 |
$0.00 |
| 96160 |
|
12 |
12 |
$0.00 |
| 3078F |
|
32 |
30 |
$0.00 |
| 90687 |
|
19 |
19 |
$0.00 |
| 99401 |
|
45 |
41 |
$0.00 |
| D0602 |
|
402 |
402 |
$0.00 |
| D1330 |
|
683 |
683 |
$0.00 |
| 97802 |
|
257 |
253 |
$0.00 |
| 90686 |
|
343 |
342 |
$0.00 |
| 3008F |
|
662 |
636 |
$0.00 |
| 90651 |
|
45 |
45 |
$0.00 |
| 1126F |
|
741 |
708 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$0.00 |
| 3074F |
|
32 |
28 |
$0.00 |
| D0603 |
|
14 |
14 |
$0.00 |
| 1000F |
|
25 |
25 |
$0.00 |
| V5008 |
Hearing screening |
51 |
51 |
$0.00 |
| 90688 |
|
35 |
35 |
$0.00 |