| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
957 |
832 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
244 |
237 |
$11K |
| D0140 |
Limited oral evaluation - problem focused |
307 |
282 |
$8K |
| D0330 |
Panoramic radiographic image |
196 |
176 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
121 |
101 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
313 |
283 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
148 |
131 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
71 |
64 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
235 |
210 |
$1K |
| D1110 |
Prophylaxis - adult |
27 |
27 |
$853.85 |
| 80061 |
Lipid panel |
87 |
71 |
$662.39 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
88 |
78 |
$537.96 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
58 |
49 |
$536.74 |
| 36415 |
Collection of venous blood by venipuncture |
569 |
495 |
$474.23 |
| 80053 |
Comprehensive metabolic panel |
76 |
61 |
$423.14 |
| 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 |
30 |
12 |
$323.62 |
| 99408 |
|
25 |
20 |
$288.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
42 |
37 |
$281.58 |
| 82607 |
|
28 |
25 |
$277.77 |
| 82947 |
|
102 |
85 |
$202.47 |
| 85027 |
|
42 |
38 |
$179.52 |
| D0230 |
Intraoral - periapical each additional radiographic image |
42 |
25 |
$178.84 |
| 81001 |
|
83 |
69 |
$131.97 |
| 82962 |
|
28 |
26 |
$50.42 |
| 81002 |
|
85 |
82 |
$46.20 |
| 81003 |
|
122 |
111 |
$29.28 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
15 |
14 |
$25.60 |
| 3008F |
|
1,657 |
1,432 |
$3.01 |
| 1160F |
|
1,194 |
981 |
$2.06 |
| 1159F |
|
1,135 |
932 |
$2.06 |
| 3074F |
|
804 |
709 |
$1.89 |
| 3078F |
|
778 |
676 |
$1.48 |
| 1125F |
|
815 |
691 |
$1.43 |
| 1126F |
|
560 |
494 |
$1.10 |
| 3079F |
|
422 |
370 |
$1.01 |
| 98960 |
|
69 |
48 |
$0.30 |
| 3077F |
|
172 |
137 |
$0.30 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
116 |
111 |
$0.12 |
| 3075F |
|
42 |
38 |
$0.04 |
| 99000 |
|
548 |
476 |
$0.00 |
| 1036F |
|
418 |
361 |
$0.00 |
| 1034F |
|
72 |
56 |
$0.00 |
| D9995 |
|
13 |
12 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
22 |
17 |
$0.00 |