| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,121 |
12,302 |
$2.06M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,415 |
5,345 |
$965K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,449 |
2,720 |
$434K |
| D0120 |
Periodic oral evaluation - established patient |
11,140 |
3,481 |
$393K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,997 |
802 |
$254K |
| D1110 |
Prophylaxis - adult |
2,310 |
1,922 |
$140K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,512 |
713 |
$122K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,108 |
771 |
$112K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
931 |
466 |
$86K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,381 |
540 |
$63K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,695 |
1,674 |
$61K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
483 |
324 |
$50K |
| D0274 |
Bitewings - four radiographic images |
2,036 |
1,922 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
420 |
246 |
$42K |
| D0220 |
Intraoral - periapical first radiographic image |
3,312 |
3,084 |
$41K |
| 90832 |
Psychotherapy, 30 minutes with patient |
330 |
167 |
$40K |
| 99441 |
|
348 |
202 |
$33K |
| 99442 |
|
314 |
179 |
$30K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
265 |
158 |
$29K |
| D0140 |
Limited oral evaluation - problem focused |
613 |
239 |
$28K |
| D0210 |
Intraoral - complete series of radiographic images |
562 |
396 |
$28K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,036 |
965 |
$23K |
| 36415 |
Collection of venous blood by venipuncture |
6,477 |
5,410 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
240 |
122 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,332 |
1,322 |
$20K |
| D1120 |
Prophylaxis - child |
537 |
530 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
205 |
114 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
186 |
117 |
$16K |
| 1000F |
|
1,799 |
1,595 |
$16K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,469 |
2,371 |
$16K |
| 97803 |
|
326 |
262 |
$16K |
| 90686 |
|
1,124 |
1,122 |
$15K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
83 |
50 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
247 |
109 |
$13K |
| 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 |
339 |
149 |
$10K |
| 93000 |
|
430 |
419 |
$7K |
| 99443 |
|
67 |
38 |
$6K |
| 99386 |
|
49 |
27 |
$6K |
| 0012A |
|
139 |
139 |
$5K |
| 0002A |
|
108 |
108 |
$4K |
| 0011A |
|
146 |
146 |
$4K |
| 0071A |
|
99 |
90 |
$4K |
| 0001A |
|
98 |
98 |
$4K |
| D9110 |
|
78 |
28 |
$4K |
| D1330 |
|
71 |
71 |
$3K |
| 0064A |
|
67 |
67 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
14 |
$2K |
| 99385 |
|
19 |
12 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
20 |
12 |
$2K |
| D1999 |
|
121 |
96 |
$1K |
| 92551 |
|
141 |
141 |
$1K |
| 90461 |
|
26 |
26 |
$1K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
15 |
15 |
$967.32 |
| 96161 |
|
499 |
495 |
$729.50 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
78 |
78 |
$705.43 |
| 99173 |
|
219 |
219 |
$648.49 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
21 |
16 |
$607.47 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$442.30 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
26 |
$340.10 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
61 |
61 |
$106.28 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$79.22 |
| 99000 |
|
4,221 |
4,164 |
$23.77 |
| 3078F |
|
13 |
13 |
$10.00 |
| 91301 |
|
114 |
111 |
$0.00 |
| 91307 |
|
17 |
15 |
$0.00 |
| 91306 |
|
15 |
15 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 91300 |
|
78 |
71 |
$0.00 |