| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
16,818 |
14,659 |
$3.24M |
| D0120 |
Periodic oral evaluation - established patient |
1,295 |
880 |
$171K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
20 |
13 |
$338.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
655 |
611 |
$108.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,260 |
1,218 |
$37.93 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
221 |
199 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
2,600 |
2,552 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
10,060 |
8,908 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
34 |
34 |
$0.00 |
| D0330 |
Panoramic radiographic image |
47 |
47 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
332 |
324 |
$0.00 |
| 99173 |
|
162 |
162 |
$0.00 |
| 90863 |
|
113 |
107 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
37 |
37 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
106 |
106 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$0.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$0.00 |
| 99201 |
|
26 |
26 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,980 |
2,813 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
224 |
224 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
450 |
449 |
$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 |
1,538 |
1,297 |
$0.00 |
| 92551 |
|
149 |
149 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
241 |
236 |
$0.00 |
| 82962 |
|
28 |
24 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
139 |
133 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
25 |
25 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
62 |
37 |
$0.00 |
| 90688 |
|
53 |
53 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
12 |
12 |
$0.00 |