| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
19,968 |
16,176 |
$2.48M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
47,398 |
42,479 |
$1.37M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,177 |
14,081 |
$618K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
6,074 |
5,870 |
$396K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,756 |
3,541 |
$261K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,605 |
3,534 |
$229K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,095 |
2,053 |
$135K |
| 99188 |
|
7,445 |
7,342 |
$101K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
10,698 |
10,358 |
$97K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17,870 |
17,275 |
$93K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,299 |
1,085 |
$71K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,182 |
1,041 |
$67K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,873 |
1,721 |
$46K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,494 |
2,456 |
$43K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,064 |
799 |
$37K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,808 |
4,533 |
$35K |
| D1110 |
Prophylaxis - adult |
990 |
977 |
$34K |
| D1120 |
Prophylaxis - child |
827 |
820 |
$30K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,833 |
2,700 |
$28K |
| D0120 |
Periodic oral evaluation - established patient |
1,045 |
1,028 |
$23K |
| D0210 |
Intraoral - complete series of radiographic images |
488 |
481 |
$21K |
| D7140 |
Extraction, erupted tooth or exposed root |
726 |
498 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,233 |
3,980 |
$17K |
| D0140 |
Limited oral evaluation - problem focused |
819 |
814 |
$12K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
240 |
155 |
$10K |
| D0274 |
Bitewings - four radiographic images |
1,514 |
1,487 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
90 |
87 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
3,647 |
3,557 |
$5K |
| 99383 |
|
85 |
82 |
$5K |
| 90686 |
|
5,094 |
4,991 |
$4K |
| 99177 |
|
8,079 |
7,656 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
98 |
79 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,109 |
981 |
$4K |
| D1206 |
Topical application of fluoride varnish |
2,382 |
2,360 |
$4K |
| 99384 |
|
46 |
45 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
427 |
396 |
$3K |
| D1330 |
|
4,866 |
4,779 |
$3K |
| 87807 |
|
771 |
738 |
$2K |
| 85018 |
|
3,049 |
3,002 |
$2K |
| 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 |
301 |
253 |
$2K |
| 99382 |
|
19 |
18 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
239 |
228 |
$1K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
151 |
143 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
13 |
$1K |
| 90670 |
|
2,361 |
2,298 |
$1K |
| 92551 |
|
7,221 |
6,861 |
$888.25 |
| 81025 |
|
364 |
346 |
$734.00 |
| 81002 |
|
818 |
772 |
$658.96 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
13 |
12 |
$593.11 |
| 99173 |
|
1,377 |
1,337 |
$483.30 |
| 90723 |
|
1,217 |
1,185 |
$442.56 |
| 90461 |
|
116 |
107 |
$408.00 |
| D1351 |
Sealant - per tooth |
82 |
27 |
$259.22 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$181.22 |
| 3074F |
|
6,128 |
5,397 |
$175.50 |
| 99441 |
|
15 |
14 |
$133.30 |
| 36415 |
Collection of venous blood by venipuncture |
2,085 |
1,969 |
$125.62 |
| 3008F |
|
10,739 |
9,511 |
$97.34 |
| 36416 |
|
2,532 |
2,392 |
$91.22 |
| 90734 |
|
416 |
388 |
$90.88 |
| 90473 |
|
25 |
25 |
$90.00 |
| 90715 |
|
63 |
60 |
$80.00 |
| 90651 |
|
438 |
414 |
$61.60 |
| 99406 |
|
13 |
12 |
$51.04 |
| 90671 |
|
99 |
94 |
$50.00 |
| 90685 |
|
105 |
103 |
$48.64 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$32.34 |
| 90647 |
|
972 |
949 |
$30.00 |
| 90710 |
|
12 |
12 |
$30.00 |
| 90633 |
|
458 |
435 |
$28.32 |
| 90474 |
|
12 |
12 |
$20.00 |
| 85014 |
|
22 |
22 |
$13.00 |
| 90696 |
|
12 |
12 |
$10.00 |
| 90656 |
|
177 |
169 |
$10.00 |
| 1000F |
|
7,138 |
6,087 |
$0.01 |
| 1126F |
|
923 |
833 |
$0.00 |
| 96127 |
|
2,672 |
2,179 |
$0.00 |
| 2000F |
|
7,267 |
6,385 |
$0.00 |
| 1220F |
|
2,634 |
2,229 |
$0.00 |
| 2001F |
|
10,661 |
9,100 |
$0.00 |
| 3351F |
|
1,588 |
1,286 |
$0.00 |
| 3079F |
|
309 |
284 |
$0.00 |
| 3510F |
|
52 |
48 |
$0.00 |
| 3044F |
|
50 |
49 |
$0.00 |
| 4000F |
|
85 |
78 |
$0.00 |
| 1111F |
|
158 |
137 |
$0.00 |
| 0513F |
|
66 |
50 |
$0.00 |
| 1034F |
|
51 |
38 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$0.00 |
| 1125F |
|
27 |
26 |
$0.00 |
| 90620 |
|
29 |
28 |
$0.00 |
| 3075F |
|
28 |
27 |
$0.00 |
| 90716 |
|
15 |
12 |
$0.00 |
| 3352F |
|
20 |
13 |
$0.00 |
| D0603 |
|
17 |
17 |
$0.00 |
| 3078F |
|
5,634 |
4,946 |
$0.00 |
| 1159F |
|
6,711 |
5,779 |
$0.00 |
| 1160F |
|
6,724 |
5,789 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
153 |
148 |
$0.00 |
| 3210F |
|
426 |
351 |
$0.00 |
| 4035F |
|
1,021 |
949 |
$0.00 |
| 4004F |
|
198 |
146 |
$0.00 |
| 3015F |
|
320 |
268 |
$0.00 |
| 90681 |
|
124 |
120 |
$0.00 |
| 2028F |
|
160 |
147 |
$0.00 |
| 90700 |
|
15 |
13 |
$0.00 |