| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
38,883 |
28,185 |
$4.55M |
| H2020 |
Therapeutic behavioral services, per diem |
41,886 |
23,681 |
$4.05M |
| D0999 |
Unspecified diagnostic procedure, by report |
6,450 |
4,237 |
$625K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48,938 |
35,195 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,126 |
995 |
$474.42 |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,104 |
1,054 |
$308.07 |
| D1110 |
Prophylaxis - adult |
984 |
696 |
$288.06 |
| 0011A |
|
25 |
12 |
$217.04 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,211 |
3,352 |
$149.00 |
| D0120 |
Periodic oral evaluation - established patient |
973 |
801 |
$136.20 |
| D0220 |
Intraoral - periapical first radiographic image |
1,327 |
1,012 |
$120.64 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
18,325 |
13,003 |
$28.92 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,813 |
1,044 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
756 |
631 |
$0.00 |
| 99348 |
|
591 |
561 |
$0.00 |
| 3078F |
|
823 |
498 |
$0.00 |
| 1159F |
|
1,194 |
717 |
$0.00 |
| 99408 |
|
331 |
218 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
91 |
81 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
561 |
479 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
566 |
409 |
$0.00 |
| D1120 |
Prophylaxis - child |
433 |
389 |
$0.00 |
| 1160F |
|
1,192 |
716 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
82 |
68 |
$0.00 |
| D0330 |
Panoramic radiographic image |
582 |
368 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
310 |
259 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
40 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
53 |
$0.00 |
| 90836 |
|
62 |
30 |
$0.00 |
| 91300 |
|
45 |
13 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
36 |
29 |
$0.00 |
| D1999 |
|
40 |
40 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
12,836 |
6,434 |
$0.00 |
| 00000 |
|
246 |
149 |
$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 |
7,456 |
5,514 |
$0.00 |
| 99335 |
|
1,198 |
1,033 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
659 |
468 |
$0.00 |
| 3074F |
|
963 |
579 |
$0.00 |
| 99406 |
|
267 |
177 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
229 |
199 |
$0.00 |
| 1125F |
|
345 |
201 |
$0.00 |
| 3008F |
|
1,316 |
793 |
$0.00 |
| 1170F |
|
813 |
486 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
293 |
250 |
$0.00 |
| 3352F |
|
138 |
92 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
280 |
121 |
$0.00 |
| 3048F |
|
205 |
131 |
$0.00 |
| 1126F |
|
382 |
240 |
$0.00 |
| 3079F |
|
281 |
175 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
60 |
53 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
65 |
63 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
31 |
24 |
$0.00 |
| 3044F |
|
301 |
171 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
49 |
27 |
$0.00 |
| 3351F |
|
366 |
226 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
21 |
12 |
$0.00 |
| 4010F |
|
43 |
27 |
$0.00 |
| 91301 |
|
134 |
62 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
109 |
58 |
$0.00 |
| 3075F |
|
35 |
20 |
$0.00 |