| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
615 |
571 |
$44K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
130 |
125 |
$15K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
133 |
127 |
$6K |
| 92370 |
|
153 |
134 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
100 |
70 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,352 |
1,272 |
$1K |
| 80053 |
Comprehensive metabolic panel |
304 |
292 |
$390.72 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
340 |
324 |
$314.69 |
| 80061 |
Lipid panel |
82 |
80 |
$120.51 |
| 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 |
6,817 |
4,855 |
$97.80 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
548 |
515 |
$42.46 |
| D1208 |
Topical application of fluoride, excluding varnish |
570 |
545 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,356 |
1,311 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,083 |
2,630 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
133 |
130 |
$0.00 |
| D2330 |
|
41 |
25 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
898 |
715 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,137 |
1,109 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,261 |
2,820 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
183 |
182 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
2,837 |
2,742 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
2,334 |
2,169 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,713 |
22,075 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
331 |
231 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
424 |
416 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,161 |
640 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
308 |
167 |
$0.00 |
| 90688 |
|
28 |
27 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
133 |
130 |
$0.00 |
| 90686 |
|
27 |
27 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
85 |
84 |
$0.00 |
| 98967 |
|
15 |
12 |
$0.00 |
| D2331 |
|
16 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
15 |
15 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
41 |
39 |
$0.00 |
| D0240 |
|
65 |
34 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
33 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
96 |
93 |
$0.00 |
| 99000 |
|
52 |
47 |
$0.00 |
| D1351 |
Sealant - per tooth |
177 |
51 |
$0.00 |
| 92250 |
|
58 |
57 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
12 |
12 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
41 |
38 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
18 |
18 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
17 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
2,518 |
2,384 |
$0.00 |
| D0270 |
|
495 |
479 |
$0.00 |
| 11721 |
|
333 |
312 |
$0.00 |
| 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 |
178 |
124 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,394 |
1,361 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,367 |
936 |
$0.00 |
| D1999 |
|
362 |
307 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,502 |
3,782 |
$0.00 |
| 92015 |
Determination of refractive state |
633 |
537 |
$0.00 |
| D1110 |
Prophylaxis - adult |
2,394 |
2,312 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,290 |
1,335 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
64 |
63 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
894 |
837 |
$0.00 |
| 99442 |
|
16 |
12 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
645 |
583 |
$0.00 |
| 81002 |
|
2,083 |
1,713 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
606 |
430 |
$0.00 |
| 81003 |
|
104 |
99 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
182 |
177 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,901 |
1,843 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
402 |
386 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
150 |
135 |
$0.00 |
| D0330 |
Panoramic radiographic image |
292 |
284 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
487 |
439 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
154 |
144 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
234 |
218 |
$0.00 |
| 90670 |
|
13 |
12 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
14 |
13 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
417 |
390 |
$0.00 |
| 99173 |
|
161 |
154 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
56 |
52 |
$0.00 |
| 98968 |
|
17 |
12 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
14 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
14 |
13 |
$0.00 |
| 90461 |
|
19 |
17 |
$0.00 |