| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,108 |
10,220 |
$412K |
| T1015 |
Clinic visit/encounter, all-inclusive |
6,246 |
4,617 |
$225K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,797 |
1,310 |
$119K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,878 |
1,592 |
$102K |
| 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 |
2,525 |
2,022 |
$65K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,462 |
853 |
$45K |
| D1120 |
Prophylaxis - child |
1,188 |
1,076 |
$35K |
| D0120 |
Periodic oral evaluation - established patient |
1,163 |
1,017 |
$23K |
| D1110 |
Prophylaxis - adult |
493 |
420 |
$22K |
| D1354 |
|
178 |
42 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
859 |
805 |
$16K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
509 |
449 |
$15K |
| D1206 |
Topical application of fluoride varnish |
702 |
606 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,469 |
1,305 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
176 |
147 |
$12K |
| 90791 |
Psychiatric diagnostic evaluation |
129 |
108 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
350 |
311 |
$9K |
| 59425 |
|
143 |
102 |
$9K |
| D0140 |
Limited oral evaluation - problem focused |
287 |
239 |
$9K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,439 |
1,228 |
$8K |
| 80061 |
Lipid panel |
1,274 |
1,090 |
$8K |
| D0210 |
Intraoral - complete series of radiographic images |
107 |
88 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
66 |
62 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
194 |
173 |
$5K |
| 90686 |
|
799 |
699 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
2,161 |
1,886 |
$5K |
| D9999 |
Unspecified adjunctive procedure, by report |
1,345 |
979 |
$4K |
| D0330 |
Panoramic radiographic image |
66 |
56 |
$4K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
48 |
27 |
$3K |
| D0274 |
Bitewings - four radiographic images |
70 |
50 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
13 |
$923.13 |
| D0220 |
Intraoral - periapical first radiographic image |
110 |
100 |
$875.96 |
| 97803 |
|
219 |
199 |
$841.56 |
| 36416 |
|
137 |
106 |
$204.74 |
| 81003 |
|
13 |
13 |
$2.25 |
| 90670 |
|
13 |
12 |
$0.00 |
| D0603 |
|
39 |
38 |
$0.00 |