| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
17,508 |
11,668 |
$1.49M |
| D0999 |
Unspecified diagnostic procedure, by report |
4,240 |
2,767 |
$181K |
| H2020 |
Therapeutic behavioral services, per diem |
1,149 |
321 |
$26K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,481 |
788 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
874 |
656 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
473 |
356 |
$3K |
| D0274 |
Bitewings - four radiographic images |
274 |
187 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
960 |
740 |
$2K |
| D1110 |
Prophylaxis - adult |
81 |
68 |
$599.42 |
| D0230 |
Intraoral - periapical each additional radiographic image |
266 |
173 |
$300.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,782 |
8,981 |
$274.07 |
| 90791 |
Psychiatric diagnostic evaluation |
225 |
157 |
$136.56 |
| D0272 |
Bitewings - two radiographic images |
167 |
144 |
$85.72 |
| 90834 |
Psychotherapy, 45 minutes with patient |
232 |
110 |
$48.83 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
14 |
13 |
$0.00 |
| 99385 |
|
59 |
48 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
814 |
613 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
61 |
59 |
$0.00 |
| 00000 |
|
141 |
60 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
22 |
$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 |
722 |
566 |
$0.00 |
| 99386 |
|
44 |
28 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
29 |
$0.00 |
| 99443 |
|
19 |
14 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
34 |
16 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,021 |
240 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,919 |
1,214 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
782 |
610 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
52 |
48 |
$0.00 |
| 99442 |
|
58 |
40 |
$0.00 |
| D1120 |
Prophylaxis - child |
25 |
25 |
$0.00 |
| 81003 |
|
26 |
12 |
$0.00 |