| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
47,067 |
41,010 |
$7.83M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,343 |
14,380 |
$2.73M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,062 |
7,983 |
$1.51M |
| D0999 |
Unspecified diagnostic procedure, by report |
827 |
669 |
$191K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
580 |
549 |
$102K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
400 |
334 |
$68K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
350 |
318 |
$61K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
246 |
226 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
146 |
137 |
$28K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
127 |
123 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
105 |
105 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
77 |
76 |
$13K |
| 0502F |
|
449 |
324 |
$12K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,113 |
1,011 |
$11K |
| 99442 |
|
40 |
39 |
$9K |
| 0011A |
|
544 |
511 |
$9K |
| 3008F |
|
37,320 |
32,757 |
$7K |
| 0012A |
|
419 |
400 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,023 |
3,719 |
$7K |
| 90686 |
|
542 |
510 |
$7K |
| 0001A |
|
322 |
304 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
106 |
101 |
$5K |
| 99383 |
|
25 |
25 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
25 |
16 |
$5K |
| 0002A |
|
243 |
239 |
$4K |
| D1110 |
Prophylaxis - adult |
56 |
56 |
$4K |
| 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 |
959 |
507 |
$4K |
| D4910 |
|
16 |
16 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
73 |
67 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
157 |
145 |
$3K |
| 99201 |
|
13 |
13 |
$2K |
| 36416 |
|
1,951 |
1,765 |
$2K |
| 0071A |
|
62 |
54 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
31 |
31 |
$2K |
| 0013A |
|
85 |
82 |
$2K |
| 0064A |
|
48 |
44 |
$2K |
| 1000F |
|
1,686 |
1,480 |
$1K |
| 81025 |
|
736 |
682 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15,453 |
13,875 |
$915.31 |
| 0004A |
|
27 |
27 |
$903.60 |
| D1120 |
Prophylaxis - child |
25 |
25 |
$884.00 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$884.00 |
| 90688 |
|
600 |
553 |
$704.99 |
| 80305 |
|
4,164 |
3,513 |
$659.75 |
| 81003 |
|
3,766 |
2,969 |
$572.19 |
| 0003A |
|
27 |
26 |
$542.36 |
| 0072A |
|
29 |
22 |
$503.54 |
| 3074F |
|
7,075 |
6,194 |
$390.40 |
| 0031A |
|
15 |
15 |
$301.18 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,211 |
667 |
$273.00 |
| 3725F |
|
7,235 |
6,663 |
$187.45 |
| 99173 |
|
219 |
210 |
$187.45 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
724 |
674 |
$126.23 |
| 87430 |
|
778 |
752 |
$109.70 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
664 |
652 |
$75.00 |
| 87400 |
|
106 |
98 |
$49.45 |
| 87428 |
|
104 |
102 |
$25.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
126 |
122 |
$24.00 |
| 85018 |
|
306 |
264 |
$8.30 |
| 3079F |
|
2,379 |
2,153 |
$0.00 |
| 3075F |
|
725 |
643 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
129 |
126 |
$0.00 |
| 3080F |
|
184 |
171 |
$0.00 |
| 3044F |
|
16 |
12 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
21 |
20 |
$0.00 |
| 92551 |
|
105 |
102 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
15 |
15 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
21 |
12 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$0.00 |
| 3078F |
|
6,000 |
5,274 |
$0.00 |
| 3077F |
|
288 |
271 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
218 |
211 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
684 |
605 |
$0.00 |
| 90715 |
|
44 |
43 |
$0.00 |
| 98926 |
|
16 |
14 |
$0.00 |