| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,044 |
20,498 |
$4.33M |
| 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 |
6,506 |
5,154 |
$305K |
| D0140 |
Limited oral evaluation - problem focused |
1,274 |
1,211 |
$89K |
| D1110 |
Prophylaxis - adult |
983 |
947 |
$57K |
| D1206 |
Topical application of fluoride varnish |
1,153 |
1,128 |
$49K |
| D1120 |
Prophylaxis - child |
688 |
668 |
$38K |
| D0220 |
Intraoral - periapical first radiographic image |
1,096 |
1,049 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,414 |
8,636 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,843 |
12,950 |
$31K |
| D7140 |
Extraction, erupted tooth or exposed root |
385 |
240 |
$30K |
| D1351 |
Sealant - per tooth |
728 |
200 |
$24K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
413 |
394 |
$22K |
| D0120 |
Periodic oral evaluation - established patient |
532 |
518 |
$16K |
| D9110 |
|
204 |
192 |
$14K |
| D0274 |
Bitewings - four radiographic images |
415 |
399 |
$12K |
| 99188 |
|
469 |
441 |
$12K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
120 |
81 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,266 |
2,086 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,540 |
1,278 |
$3K |
| D0330 |
Panoramic radiographic image |
66 |
61 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
107 |
82 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
28 |
26 |
$649.61 |
| 36415 |
Collection of venous blood by venipuncture |
6,631 |
5,805 |
$604.58 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
95 |
85 |
$581.56 |
| 90832 |
Psychotherapy, 30 minutes with patient |
298 |
171 |
$284.80 |
| 99000 |
|
3,385 |
2,808 |
$284.66 |
| D0603 |
|
114 |
106 |
$259.85 |
| D1310 |
|
32 |
30 |
$257.86 |
| D0270 |
|
12 |
12 |
$246.13 |
| 0031A |
|
13 |
13 |
$63.50 |
| 82962 |
|
13 |
13 |
$51.81 |
| 92551 |
|
91 |
89 |
$33.09 |
| 99173 |
|
119 |
117 |
$5.80 |
| 99406 |
|
35 |
32 |
$5.56 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
115 |
114 |
$0.00 |
| 81002 |
|
165 |
157 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
64 |
59 |
$0.00 |
| G0127 |
Trimming of dystrophic nails, any number |
27 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
26 |
25 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
259 |
252 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
254 |
149 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
37 |
27 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
24 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
13 |
$0.00 |
| D1330 |
|
17 |
16 |
$0.00 |