| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90837 |
Psychotherapy, 53 minutes with patient |
836 |
515 |
$395K |
| D0999 |
Unspecified diagnostic procedure, by report |
396 |
372 |
$266K |
| 90834 |
Psychotherapy, 45 minutes with patient |
212 |
168 |
$99K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
128 |
120 |
$91K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50 |
47 |
$35K |
| 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 |
158 |
74 |
$30K |
| D1110 |
Prophylaxis - adult |
97 |
76 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$9K |
| D1330 |
|
231 |
205 |
$6K |
| D1206 |
Topical application of fluoride varnish |
160 |
145 |
$6K |
| D1120 |
Prophylaxis - child |
83 |
62 |
$5K |
| D0274 |
Bitewings - four radiographic images |
19 |
12 |
$2K |
| D0330 |
Panoramic radiographic image |
20 |
12 |
$1K |
| 98968 |
|
24 |
12 |
$897.84 |
| D1310 |
|
17 |
12 |
$519.00 |
| D0190 |
|
42 |
41 |
$519.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$349.00 |