| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
100,908 |
62,817 |
$9.45M |
| D0999 |
Unspecified diagnostic procedure, by report |
37,291 |
33,047 |
$4.43M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
9,058 |
5,820 |
$681K |
| 90791 |
Psychiatric diagnostic evaluation |
3,949 |
3,126 |
$15K |
| 90832 |
Psychotherapy, 30 minutes with patient |
28,208 |
17,014 |
$11K |
| 90837 |
Psychotherapy, 53 minutes with patient |
5,014 |
3,146 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,153 |
3,614 |
$2K |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
72 |
50 |
$883.73 |
| D0120 |
Periodic oral evaluation - established patient |
7,383 |
7,197 |
$662.40 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,472 |
17,220 |
$374.73 |
| D7140 |
Extraction, erupted tooth or exposed root |
7,598 |
5,707 |
$279.00 |
| D9110 |
|
5,616 |
5,364 |
$270.80 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,573 |
12,479 |
$242.97 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,509 |
7,060 |
$225.25 |
| D0140 |
Limited oral evaluation - problem focused |
5,260 |
5,056 |
$220.80 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,081 |
2,724 |
$195.40 |
| D0220 |
Intraoral - periapical first radiographic image |
11,717 |
11,136 |
$110.40 |
| D1206 |
Topical application of fluoride varnish |
7,596 |
7,420 |
$110.40 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,702 |
2,642 |
$110.40 |
| D0272 |
Bitewings - two radiographic images |
3,496 |
3,398 |
$110.40 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,290 |
1,104 |
$85.65 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
261 |
197 |
$33.60 |
| 80305 |
|
2,074 |
1,593 |
$17.96 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,004 |
1,753 |
$12.30 |
| D0270 |
|
5,155 |
4,991 |
$5.60 |
| 81002 |
|
621 |
564 |
$5.20 |
| 81025 |
|
3,620 |
3,044 |
$5.16 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,181 |
1,032 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
310 |
287 |
$0.00 |
| D2140 |
|
699 |
633 |
$0.00 |
| 99201 |
|
602 |
449 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
283 |
274 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
3,690 |
3,604 |
$0.00 |
| D1110 |
Prophylaxis - adult |
350 |
346 |
$0.00 |
| D0330 |
Panoramic radiographic image |
5,004 |
4,885 |
$0.00 |
| D1120 |
Prophylaxis - child |
7,982 |
7,796 |
$0.00 |
| D2332 |
|
139 |
129 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
213 |
189 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
436 |
358 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
458 |
417 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
26 |
12 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
387 |
348 |
$0.00 |
| 82948 |
|
33 |
33 |
$0.00 |
| D2950 |
|
13 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
132 |
130 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
39 |
$0.00 |
| 96160 |
|
18 |
13 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |
| 87210 |
|
21 |
12 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
552 |
531 |
$0.00 |
| D1351 |
Sealant - per tooth |
2,580 |
1,397 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
285 |
285 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,417 |
2,318 |
$0.00 |
| D2330 |
|
190 |
170 |
$0.00 |
| D7230 |
|
15 |
14 |
$0.00 |
| 99383 |
|
18 |
17 |
$0.00 |
| 81000 |
|
1,534 |
1,250 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,987 |
2,711 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
1,132 |
534 |
$0.00 |
| D2160 |
|
111 |
98 |
$0.00 |
| 85018 |
|
495 |
442 |
$0.00 |
| D2331 |
|
332 |
303 |
$0.00 |
| D2335 |
|
190 |
175 |
$0.00 |
| D9310 |
|
135 |
135 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
35 |
13 |
$0.00 |