| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,598 |
20,566 |
$3.69M |
| H2020 |
Therapeutic behavioral services, per diem |
12,311 |
6,140 |
$1.21M |
| D0999 |
Unspecified diagnostic procedure, by report |
4,778 |
3,251 |
$517K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,839 |
15,535 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
580 |
459 |
$615.81 |
| 0001A |
|
80 |
35 |
$594.96 |
| 0003A |
|
86 |
42 |
$569.66 |
| 90832 |
Psychotherapy, 30 minutes with patient |
7,454 |
3,383 |
$552.22 |
| D0210 |
Intraoral - complete series of radiographic images |
379 |
304 |
$541.53 |
| 99050 |
|
62 |
39 |
$409.68 |
| D1110 |
Prophylaxis - adult |
274 |
216 |
$336.07 |
| 0031A |
|
34 |
17 |
$185.40 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,235 |
1,010 |
$124.36 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
210 |
118 |
$72.36 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,578 |
1,085 |
$69.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
75 |
63 |
$44.10 |
| D0120 |
Periodic oral evaluation - established patient |
22 |
12 |
$27.24 |
| 81002 |
|
1,235 |
1,003 |
$20.30 |
| 90658 |
|
15 |
15 |
$15.37 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
364 |
259 |
$10.75 |
| 36416 |
|
525 |
427 |
$4.04 |
| 36415 |
Collection of venous blood by venipuncture |
1,017 |
592 |
$1.72 |
| 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 |
173 |
148 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,414 |
1,839 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
205 |
164 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
194 |
159 |
$0.00 |
| 90839 |
|
36 |
26 |
$0.00 |
| 99385 |
|
13 |
12 |
$0.00 |
| 86710 |
|
31 |
13 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
75 |
37 |
$0.00 |
| 92551 |
|
17 |
17 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
19 |
12 |
$0.00 |
| 91303 |
|
34 |
17 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16 |
13 |
$0.00 |
| 86703 |
|
116 |
80 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
836 |
537 |
$0.00 |
| 81025 |
|
295 |
239 |
$0.00 |
| 82948 |
|
568 |
417 |
$0.00 |
| 96160 |
|
195 |
140 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
521 |
244 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 99173 |
|
17 |
17 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
15 |
13 |
$0.00 |
| 90863 |
|
180 |
108 |
$0.00 |
| 91300 |
|
161 |
72 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |
| 90756 |
|
19 |
18 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
18 |
13 |
$0.00 |