| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
6,046 |
5,087 |
$2.35M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,389 |
7,221 |
$1.77M |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,522 |
1,145 |
$704K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,127 |
567 |
$357K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,271 |
1,126 |
$270K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
367 |
336 |
$78K |
| D1110 |
Prophylaxis - adult |
2,552 |
2,218 |
$51K |
| D1206 |
Topical application of fluoride varnish |
2,570 |
2,276 |
$27K |
| D0274 |
Bitewings - four radiographic images |
593 |
506 |
$9K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
29 |
27 |
$8K |
| D1120 |
Prophylaxis - child |
574 |
543 |
$5K |
| D0330 |
Panoramic radiographic image |
188 |
161 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
135 |
98 |
$3K |
| D0180 |
|
130 |
113 |
$3K |
| 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 |
111 |
84 |
$2K |
| 0012A |
|
26 |
26 |
$1K |
| 0011A |
|
27 |
27 |
$794.16 |
| D0272 |
Bitewings - two radiographic images |
71 |
60 |
$450.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
111 |
109 |
$348.46 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$133.00 |
| 90688 |
|
16 |
15 |
$33.98 |
| 36415 |
Collection of venous blood by venipuncture |
293 |
277 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
16 |
15 |
$0.00 |