| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,041 |
9,229 |
$589K |
| T1015 |
Clinic visit/encounter, all-inclusive |
15,307 |
10,742 |
$209K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,571 |
1,062 |
$127K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,807 |
1,844 |
$97K |
| D9999 |
Unspecified adjunctive procedure, by report |
1,461 |
1,119 |
$90K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,271 |
1,698 |
$77K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,422 |
995 |
$43K |
| D1110 |
Prophylaxis - adult |
470 |
294 |
$18K |
| 90791 |
Psychiatric diagnostic evaluation |
267 |
236 |
$18K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
471 |
212 |
$12K |
| D0330 |
Panoramic radiographic image |
179 |
119 |
$8K |
| D1206 |
Topical application of fluoride varnish |
438 |
312 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
393 |
284 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
542 |
346 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
93 |
71 |
$3K |
| 87428 |
|
108 |
85 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
35 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
27 |
$2K |
| D1120 |
Prophylaxis - child |
91 |
69 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
139 |
109 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
187 |
54 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
119 |
71 |
$1K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
160 |
51 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
16 |
$1K |
| D0274 |
Bitewings - four radiographic images |
37 |
37 |
$773.73 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$723.58 |
| 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 |
181 |
56 |
$551.48 |
| D0220 |
Intraoral - periapical first radiographic image |
85 |
73 |
$547.33 |
| 98940 |
|
18 |
12 |
$424.80 |
| 90785 |
|
73 |
54 |
$422.46 |
| D0230 |
Intraoral - periapical each additional radiographic image |
85 |
32 |
$343.00 |
| 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 |
36 |
14 |
$197.88 |
| 90686 |
|
95 |
59 |
$182.68 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
12 |
$150.01 |