| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,974 |
9,275 |
$838K |
| 99199 |
Unlisted special service, procedure or report |
124,094 |
68,765 |
$705K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,816 |
1,460 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
690 |
595 |
$12K |
| D0330 |
Panoramic radiographic image |
154 |
129 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
166 |
128 |
$5K |
| 92587 |
|
459 |
321 |
$5K |
| D0274 |
Bitewings - four radiographic images |
188 |
159 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
29 |
$3K |
| 99383 |
|
35 |
25 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,066 |
896 |
$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 |
94 |
64 |
$821.60 |
| 96127 |
|
654 |
442 |
$629.33 |
| 99173 |
|
511 |
359 |
$276.83 |
| D0220 |
Intraoral - periapical first radiographic image |
48 |
22 |
$267.46 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
17 |
16 |
$205.24 |
| 82947 |
|
41 |
39 |
$170.14 |
| D0230 |
Intraoral - periapical each additional radiographic image |
28 |
12 |
$126.79 |
| 80053 |
Comprehensive metabolic panel |
17 |
12 |
$11.28 |
| D0190 |
|
73 |
61 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
69 |
49 |
$0.00 |
| 99000 |
|
227 |
160 |
$0.00 |