| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0220 |
Intraoral - periapical first radiographic image |
4,447 |
4,263 |
$0.00 |
| D0270 |
|
2,041 |
1,988 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
3,518 |
3,467 |
$0.00 |
| 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 |
261 |
240 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,126 |
883 |
$0.00 |
| 80305 |
|
2,084 |
1,206 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,419 |
1,086 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
1,146 |
1,065 |
$0.00 |
| D1110 |
Prophylaxis - adult |
3,582 |
3,542 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,096 |
1,083 |
$0.00 |
| D0330 |
Panoramic radiographic image |
3,050 |
2,998 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
6,476 |
3,533 |
$0.00 |
| 81003 |
|
428 |
394 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
223 |
214 |
$0.00 |
| 83037 |
|
139 |
129 |
$0.00 |
| 81002 |
|
112 |
98 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,125 |
649 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
64 |
61 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
61 |
58 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
268 |
261 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$0.00 |
| 99499 |
|
142 |
132 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
419 |
126 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
70 |
67 |
$0.00 |
| 98968 |
|
48 |
31 |
$0.00 |
| D2950 |
|
15 |
14 |
$0.00 |
| 81025 |
|
13 |
13 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
12 |
12 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
48 |
45 |
$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 |
3,404 |
2,732 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
3,258 |
1,525 |
$0.00 |
| 82962 |
|
697 |
670 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
4,715 |
4,543 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,975 |
6,914 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
4,310 |
4,260 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,719 |
2,668 |
$0.00 |
| D9995 |
|
82 |
79 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
968 |
909 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,681 |
1,263 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
2,448 |
2,422 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,555 |
10,845 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
696 |
686 |
$0.00 |
| H2035 |
Alcohol and/or other drug treatment program, per hour |
65 |
34 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
164 |
143 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,443 |
684 |
$0.00 |
| D1351 |
Sealant - per tooth |
98 |
25 |
$0.00 |
| 90688 |
|
166 |
149 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,187 |
851 |
$0.00 |
| D1330 |
|
75 |
75 |
$0.00 |
| 98967 |
|
42 |
36 |
$0.00 |
| T1016 |
Case management, each 15 minutes |
396 |
229 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
176 |
174 |
$0.00 |
| D2331 |
|
34 |
25 |
$0.00 |
| 90686 |
|
246 |
245 |
$0.00 |
| 90656 |
|
35 |
35 |
$0.00 |
| 90651 |
|
18 |
14 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
177 |
104 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
54 |
52 |
$0.00 |
| D1310 |
|
49 |
49 |
$0.00 |
| D2330 |
|
17 |
14 |
$0.00 |