| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,890 |
16,470 |
$696K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,910 |
4,434 |
$250K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,480 |
4,727 |
$181K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
624 |
575 |
$49K |
| D1110 |
Prophylaxis - adult |
1,625 |
1,612 |
$47K |
| D0330 |
Panoramic radiographic image |
881 |
880 |
$43K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
384 |
354 |
$40K |
| 90837 |
Psychotherapy, 53 minutes with patient |
555 |
387 |
$40K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
625 |
570 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
454 |
417 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
427 |
392 |
$30K |
| 90834 |
Psychotherapy, 45 minutes with patient |
486 |
368 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
401 |
320 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
300 |
263 |
$19K |
| D0140 |
Limited oral evaluation - problem focused |
1,764 |
1,742 |
$18K |
| D0274 |
Bitewings - four radiographic images |
1,058 |
1,055 |
$16K |
| D1120 |
Prophylaxis - child |
303 |
300 |
$11K |
| D0120 |
Periodic oral evaluation - established patient |
846 |
839 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,554 |
1,370 |
$8K |
| 99406 |
|
1,337 |
1,213 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
95 |
84 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
875 |
611 |
$7K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
106 |
91 |
$5K |
| 90887 |
|
352 |
314 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
61 |
48 |
$5K |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
175 |
143 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
548 |
547 |
$4K |
| D1206 |
Topical application of fluoride varnish |
1,253 |
1,241 |
$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 |
3,016 |
2,140 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
117 |
97 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
42 |
41 |
$3K |
| 99381 |
|
45 |
39 |
$3K |
| 99188 |
|
295 |
253 |
$3K |
| 87428 |
|
168 |
138 |
$3K |
| 0001A |
|
73 |
63 |
$2K |
| D1351 |
Sealant - per tooth |
121 |
37 |
$2K |
| 80305 |
|
385 |
341 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
3,176 |
3,135 |
$2K |
| 0002A |
|
42 |
40 |
$2K |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
201 |
155 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
377 |
342 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
595 |
527 |
$975.27 |
| 0011A |
|
24 |
24 |
$960.00 |
| 0012A |
|
24 |
24 |
$960.00 |
| 0031A |
|
26 |
22 |
$800.00 |
| 93000 |
|
125 |
114 |
$773.35 |
| 99384 |
|
15 |
13 |
$728.59 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,666 |
1,598 |
$606.73 |
| D1310 |
|
403 |
400 |
$445.90 |
| 85018 |
|
634 |
569 |
$427.52 |
| D7140 |
Extraction, erupted tooth or exposed root |
15 |
12 |
$392.63 |
| 87806 |
|
39 |
39 |
$284.49 |
| 72100 |
|
13 |
12 |
$264.67 |
| 81003 |
|
275 |
241 |
$245.19 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
48 |
40 |
$238.20 |
| 81025 |
|
169 |
157 |
$232.35 |
| 71046 |
Radiologic examination, chest; 2 views |
12 |
12 |
$202.87 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
35 |
27 |
$197.20 |
| 73630 |
|
16 |
13 |
$161.95 |
| 90686 |
|
271 |
253 |
$132.00 |
| 97802 |
|
1,103 |
1,005 |
$119.27 |
| 90651 |
|
136 |
127 |
$99.51 |
| 3078F |
|
9,000 |
7,783 |
$97.90 |
| 90633 |
|
47 |
43 |
$89.51 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$79.44 |
| 83655 |
|
16 |
16 |
$76.53 |
| 1000F |
|
14,606 |
12,230 |
$68.26 |
| 1159F |
|
17,084 |
15,006 |
$53.72 |
| 3074F |
|
10,132 |
9,124 |
$36.04 |
| 81002 |
|
54 |
51 |
$27.17 |
| 1160F |
|
16,896 |
14,858 |
$14.18 |
| D0603 |
|
250 |
250 |
$11.00 |
| 99408 |
|
2,544 |
2,120 |
$0.47 |
| 3079F |
|
4,290 |
3,638 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
3,226 |
2,493 |
$0.00 |
| 96127 |
|
289 |
253 |
$0.00 |
| 92551 |
|
1,331 |
1,179 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,194 |
1,094 |
$0.00 |
| 1036F |
|
12,116 |
10,182 |
$0.00 |
| 1126F |
|
6,820 |
6,213 |
$0.00 |
| 3008F |
|
1,046 |
968 |
$0.00 |
| 3075F |
|
1,693 |
1,542 |
$0.00 |
| D0602 |
|
419 |
419 |
$0.00 |
| 1170F |
|
691 |
623 |
$0.00 |
| 3044F |
|
83 |
81 |
$0.00 |
| 1125F |
|
3,479 |
3,140 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
3,123 |
2,666 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
642 |
576 |
$0.00 |
| 3080F |
|
464 |
403 |
$0.00 |
| 90620 |
|
38 |
37 |
$0.00 |
| 1111F |
|
575 |
509 |
$0.00 |
| 90723 |
|
90 |
79 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
221 |
186 |
$0.00 |
| 90647 |
|
77 |
72 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
28 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
48 |
48 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
16 |
14 |
$0.00 |
| 99173 |
|
1,311 |
1,158 |
$0.00 |
| 3288F |
|
736 |
661 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
5,776 |
4,902 |
$0.00 |
| 90863 |
|
357 |
305 |
$0.00 |
| 83037 |
|
281 |
255 |
$0.00 |
| 96167 |
|
802 |
650 |
$0.00 |
| 90670 |
|
135 |
122 |
$0.00 |
| 0518F |
|
288 |
261 |
$0.00 |
| 3077F |
|
1,041 |
915 |
$0.00 |
| 96160 |
|
82 |
70 |
$0.00 |
| 90734 |
|
97 |
92 |
$0.00 |
| 90461 |
|
29 |
25 |
$0.00 |
| 1158F |
|
224 |
203 |
$0.00 |
| 99080 |
|
12 |
12 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |