| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
5,797 |
5,272 |
$155K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,186 |
7,094 |
$94K |
| D0210 |
Intraoral - complete series of radiographic images |
1,665 |
1,600 |
$75K |
| D1999 |
|
5,454 |
5,137 |
$75K |
| D0120 |
Periodic oral evaluation - established patient |
5,012 |
4,571 |
$72K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35,404 |
27,635 |
$58K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,380 |
3,269 |
$57K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,255 |
2,980 |
$54K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,202 |
2,028 |
$47K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,668 |
2,446 |
$38K |
| D0272 |
Bitewings - two radiographic images |
2,259 |
1,998 |
$33K |
| S9083 |
Global fee urgent care centers |
1,245 |
1,021 |
$31K |
| D1120 |
Prophylaxis - child |
1,437 |
1,322 |
$27K |
| 0001A |
|
742 |
723 |
$23K |
| 0002A |
|
573 |
545 |
$20K |
| 71046 |
Radiologic examination, chest; 2 views |
931 |
810 |
$17K |
| 0003A |
|
438 |
436 |
$17K |
| 72100 |
|
708 |
544 |
$15K |
| 90670 |
|
1,340 |
960 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
674 |
627 |
$11K |
| 0012A |
|
275 |
275 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
1,335 |
1,089 |
$11K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
795 |
763 |
$10K |
| 90677 |
|
193 |
141 |
$8K |
| 72040 |
|
324 |
257 |
$8K |
| 90656 |
|
662 |
606 |
$8K |
| 0072A |
|
192 |
192 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
366 |
358 |
$7K |
| 73030 |
|
252 |
193 |
$6K |
| 0071A |
|
181 |
181 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
651 |
378 |
$6K |
| 71045 |
Radiologic examination, chest; single view |
341 |
276 |
$5K |
| 0031A |
|
123 |
123 |
$4K |
| 90620 |
|
206 |
188 |
$4K |
| 90658 |
|
3,068 |
2,372 |
$4K |
| 0011A |
|
94 |
91 |
$4K |
| 90734 |
|
698 |
534 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
1,806 |
1,755 |
$3K |
| 0124A |
|
78 |
73 |
$3K |
| 99441 |
|
8,247 |
7,674 |
$3K |
| 90474 |
|
363 |
225 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,723 |
3,969 |
$2K |
| 97802 |
|
219 |
170 |
$2K |
| 90714 |
|
595 |
376 |
$2K |
| 90649 |
|
733 |
560 |
$2K |
| 73560 |
|
50 |
29 |
$1K |
| 96160 |
|
119 |
109 |
$1K |
| 97803 |
|
190 |
159 |
$1K |
| 90716 |
|
543 |
402 |
$1K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
1,638 |
1,387 |
$907.12 |
| 0004A |
|
27 |
24 |
$840.00 |
| 90715 |
|
413 |
314 |
$752.71 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
32 |
26 |
$739.50 |
| 90707 |
|
473 |
359 |
$665.89 |
| G0008 |
Administration of influenza virus vaccine |
265 |
264 |
$594.58 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,278 |
4,255 |
$553.05 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
112 |
108 |
$451.44 |
| 73630 |
|
13 |
12 |
$430.44 |
| 74018 |
|
21 |
21 |
$391.54 |
| 70210 |
|
13 |
12 |
$371.48 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$370.32 |
| 96127 |
|
8,444 |
7,623 |
$362.80 |
| 90698 |
|
302 |
174 |
$331.50 |
| 90651 |
|
72 |
54 |
$269.84 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,492 |
1,252 |
$247.08 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
115 |
89 |
$233.47 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,507 |
1,275 |
$182.45 |
| 91307 |
|
392 |
367 |
$160.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
35 |
26 |
$126.35 |
| G0009 |
Administration of pneumococcal vaccine |
69 |
69 |
$95.90 |
| 90680 |
|
120 |
75 |
$83.79 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
744 |
638 |
$80.97 |
| 99442 |
|
305 |
296 |
$73.61 |
| 90686 |
|
143 |
138 |
$65.15 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
229 |
128 |
$43.71 |
| 99408 |
|
8,467 |
7,606 |
$36.16 |
| 90744 |
|
99 |
65 |
$27.50 |
| 1157F |
|
13 |
13 |
$11.76 |
| 1158F |
|
13 |
13 |
$11.76 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
862 |
758 |
$11.66 |
| 90655 |
|
107 |
104 |
$6.00 |
| 90700 |
|
316 |
215 |
$4.00 |
| 91303 |
|
119 |
119 |
$0.18 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,331 |
4,996 |
$0.00 |
| 1000F |
|
3,310 |
2,564 |
$0.00 |
| 3008F |
|
13,433 |
9,897 |
$0.00 |
| 3080F |
|
289 |
194 |
$0.00 |
| 1170F |
|
6,009 |
4,550 |
$0.00 |
| 1126F |
|
9,506 |
6,966 |
$0.00 |
| 99368 |
|
2,778 |
2,503 |
$0.00 |
| 93000 |
|
111 |
95 |
$0.00 |
| 3074F |
|
7,112 |
5,254 |
$0.00 |
| 3075F |
|
2,666 |
2,033 |
$0.00 |
| 1125F |
|
811 |
579 |
$0.00 |
| 1036F |
|
2,405 |
1,490 |
$0.00 |
| 3044F |
|
583 |
520 |
$0.00 |
| 99050 |
|
430 |
358 |
$0.00 |
| D9995 |
|
14 |
14 |
$0.00 |
| 3079F |
|
3,154 |
2,428 |
$0.00 |
| 1030F |
|
14 |
14 |
$0.00 |
| 3351F |
|
247 |
240 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
15 |
15 |
$0.00 |
| 1101F |
|
13 |
13 |
$0.00 |
| 96161 |
|
31 |
16 |
$0.00 |
| 3048F |
|
183 |
169 |
$0.00 |
| 90697 |
|
79 |
56 |
$0.00 |
| 3049F |
|
103 |
94 |
$0.00 |
| 99406 |
|
16 |
15 |
$0.00 |
| G8410 |
Footwear evaluation performed and documented |
13 |
13 |
$0.00 |
| 3061F |
|
12 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
162 |
96 |
$0.00 |
| 1136F |
|
61 |
23 |
$0.00 |
| 91301 |
|
373 |
370 |
$0.00 |
| 1111F |
|
53 |
53 |
$0.00 |
| 1022F |
|
12 |
12 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
45 |
45 |
$0.00 |
| 90723 |
|
54 |
28 |
$0.00 |
| 90696 |
|
30 |
28 |
$0.00 |
| 1159F |
|
10,591 |
8,130 |
$0.00 |
| 3077F |
|
1,375 |
1,028 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,205 |
1,013 |
$0.00 |
| 1160F |
|
7,264 |
6,144 |
$0.00 |
| 3725F |
|
4,308 |
3,961 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
822 |
640 |
$0.00 |
| 0521F |
|
2,884 |
2,309 |
$0.00 |
| 3078F |
|
8,203 |
6,090 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
230 |
147 |
$0.00 |
| 99347 |
|
254 |
193 |
$0.00 |
| 91300 |
|
1,941 |
1,739 |
$0.00 |
| 2028F |
|
37 |
37 |
$0.00 |
| 90648 |
|
340 |
232 |
$0.00 |
| 99173 |
|
802 |
687 |
$0.00 |
| 90713 |
|
145 |
105 |
$0.00 |
| 90633 |
|
401 |
286 |
$0.00 |
| 3045F |
|
41 |
33 |
$0.00 |
| 91312 |
|
80 |
75 |
$0.00 |
| 90681 |
|
30 |
25 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
58 |
42 |
$0.00 |
| 3050F |
|
56 |
48 |
$0.00 |
| S0390 |
Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit |
13 |
13 |
$0.00 |
| G0141 |
Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician |
80 |
34 |
$0.00 |
| 99348 |
|
31 |
30 |
$0.00 |
| 6100F |
|
34 |
26 |
$0.00 |
| 0518F |
|
13 |
13 |
$0.00 |
| 1090F |
|
13 |
13 |
$0.00 |
| G2010 |
Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment |
18 |
14 |
$0.00 |
| G0247 |
Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails |
12 |
12 |
$0.00 |
| G0246 |
Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot and toe web spaces, (b) evaluation of protective sensation, (c) evaluation of foot structure and biomechanics, (d) evaluation of vascular status and skin integrity, and (e) evaluation and recommendation of footwear, and (3) patient education |
48 |
43 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
15 |
$0.00 |