| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
25,113 |
15,785 |
$2.36M |
| H2020 |
Therapeutic behavioral services, per diem |
6,933 |
3,903 |
$686K |
| D0999 |
Unspecified diagnostic procedure, by report |
6,744 |
4,954 |
$624K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,687 |
675 |
$3K |
| 0001A |
|
617 |
212 |
$2K |
| 0011A |
|
531 |
241 |
$2K |
| 0012A |
|
579 |
233 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
944 |
748 |
$1K |
| 0002A |
|
521 |
140 |
$976.20 |
| D0210 |
Intraoral - complete series of radiographic images |
593 |
436 |
$849.60 |
| D0140 |
Limited oral evaluation - problem focused |
629 |
420 |
$796.79 |
| D1110 |
Prophylaxis - adult |
443 |
363 |
$725.91 |
| 0003A |
|
54 |
21 |
$259.10 |
| 0054A |
|
88 |
24 |
$222.48 |
| 0071A |
|
267 |
106 |
$222.18 |
| D0220 |
Intraoral - periapical first radiographic image |
529 |
349 |
$198.01 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,240 |
1,692 |
$139.43 |
| 0031A |
|
55 |
28 |
$104.80 |
| 0072A |
|
69 |
26 |
$74.16 |
| 0064A |
|
123 |
19 |
$74.16 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,214 |
1,500 |
$62.65 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,922 |
10,042 |
$41.53 |
| 36415 |
Collection of venous blood by venipuncture |
2,960 |
1,954 |
$2.15 |
| 91301 |
|
883 |
403 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
277 |
171 |
$0.00 |
| 90674 |
|
14 |
12 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
94 |
85 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
128 |
98 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
121 |
93 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
825 |
412 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
720 |
335 |
$0.00 |
| 36416 |
|
182 |
160 |
$0.00 |
| 92551 |
|
42 |
38 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
239 |
153 |
$0.00 |
| 91305 |
|
207 |
64 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
266 |
169 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
118 |
97 |
$0.00 |
| 85018 |
|
43 |
37 |
$0.00 |
| 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 |
14 |
13 |
$0.00 |
| 90656 |
|
16 |
16 |
$0.00 |
| 91303 |
|
48 |
24 |
$0.00 |
| 91306 |
|
123 |
19 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
2,330 |
1,655 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
582 |
389 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,400 |
838 |
$0.00 |
| 80061 |
Lipid panel |
249 |
161 |
$0.00 |
| 99173 |
|
64 |
57 |
$0.00 |
| 91300 |
|
1,431 |
487 |
$0.00 |
| 81002 |
|
251 |
219 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
275 |
214 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
61 |
52 |
$0.00 |
| 99201 |
|
156 |
84 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 96160 |
|
74 |
67 |
$0.00 |
| 90836 |
|
296 |
125 |
$0.00 |
| 90838 |
|
18 |
14 |
$0.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
16 |
14 |
$0.00 |