| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,936 |
6,596 |
$2.36M |
| D0999 |
Unspecified diagnostic procedure, by report |
1,647 |
1,459 |
$488K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,185 |
2,043 |
$132K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,136 |
1,036 |
$57K |
| 90832 |
Psychotherapy, 30 minutes with patient |
319 |
263 |
$9K |
| 99215 |
Prolong outpt/office vis |
157 |
137 |
$5K |
| 90834 |
Psychotherapy, 45 minutes with patient |
75 |
64 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
49 |
49 |
$2K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
26 |
26 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
12 |
12 |
$1K |
| 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 |
25 |
25 |
$832.80 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$825.22 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$381.61 |
| D0274 |
Bitewings - four radiographic images |
105 |
104 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
83 |
80 |
$0.00 |
| D1120 |
Prophylaxis - child |
81 |
81 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
360 |
358 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
87 |
86 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
388 |
381 |
$0.00 |
| D0601 |
|
223 |
222 |
$0.00 |
| D0603 |
|
170 |
167 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
101 |
50 |
$0.00 |