| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,076 |
17,490 |
$2.29M |
| D0999 |
Unspecified diagnostic procedure, by report |
8,459 |
7,020 |
$2.05M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,600 |
5,125 |
$684K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,077 |
963 |
$144K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,719 |
2,688 |
$68K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
403 |
388 |
$47K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
297 |
296 |
$43K |
| D1110 |
Prophylaxis - adult |
1,406 |
1,369 |
$39K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
207 |
203 |
$37K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
225 |
176 |
$34K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
162 |
157 |
$33K |
| D0120 |
Periodic oral evaluation - established patient |
1,483 |
1,445 |
$27K |
| H0031 |
Mental health assessment, by non-physician |
170 |
133 |
$26K |
| D0274 |
Bitewings - four radiographic images |
953 |
915 |
$24K |
| 90686 |
|
527 |
522 |
$23K |
| 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 |
790 |
639 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
124 |
123 |
$19K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
572 |
552 |
$16K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
258 |
192 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
112 |
112 |
$12K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
399 |
269 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
58 |
53 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
906 |
887 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
802 |
778 |
$7K |
| D1120 |
Prophylaxis - child |
131 |
127 |
$5K |
| D7140 |
Extraction, erupted tooth or exposed root |
40 |
24 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
77 |
76 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
274 |
260 |
$3K |
| D0330 |
Panoramic radiographic image |
77 |
72 |
$3K |
| 90682 |
|
50 |
50 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
43 |
43 |
$2K |
| 90461 |
|
197 |
196 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
53 |
53 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
87 |
52 |
$1K |
| 99000 |
|
1,682 |
1,604 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
335 |
304 |
$856.75 |
| D1206 |
Topical application of fluoride varnish |
1,761 |
1,691 |
$815.70 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
4,381 |
3,940 |
$667.86 |
| D0190 |
|
46 |
46 |
$605.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
121 |
115 |
$456.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,822 |
2,732 |
$387.25 |
| 81003 |
|
561 |
520 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
63 |
58 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
135 |
134 |
$0.00 |
| 90688 |
|
50 |
49 |
$0.00 |
| 36416 |
|
13 |
13 |
$0.00 |