| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
17,896 |
14,261 |
$2.23M |
| D0999 |
Unspecified diagnostic procedure, by report |
10,160 |
6,687 |
$1.03M |
| H2020 |
Therapeutic behavioral services, per diem |
1,487 |
333 |
$84K |
| D0210 |
Intraoral - complete series of radiographic images |
2,037 |
1,537 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,101 |
1,587 |
$7K |
| 99051 |
|
435 |
311 |
$5K |
| D1110 |
Prophylaxis - adult |
1,215 |
895 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
232 |
169 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
304 |
254 |
$814.14 |
| D0220 |
Intraoral - periapical first radiographic image |
156 |
111 |
$249.73 |
| D0274 |
Bitewings - four radiographic images |
247 |
199 |
$167.28 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,087 |
3,494 |
$62.65 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,046 |
5,914 |
$49.84 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,115 |
1,663 |
$0.00 |
| 99173 |
|
445 |
366 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,728 |
345 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
231 |
199 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
95 |
84 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
38 |
26 |
$0.00 |
| 90756 |
|
91 |
73 |
$0.00 |
| 92552 |
|
103 |
93 |
$0.00 |
| 81003 |
|
47 |
37 |
$0.00 |
| 90661 |
|
18 |
14 |
$0.00 |
| 80061 |
Lipid panel |
16 |
13 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
15 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
13 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
50 |
44 |
$0.00 |
| 81025 |
|
18 |
13 |
$0.00 |
| 11721 |
|
13 |
13 |
$0.00 |
| 90715 |
|
13 |
12 |
$0.00 |
| 87400 |
|
16 |
14 |
$0.00 |
| 82962 |
|
3,045 |
2,346 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
478 |
400 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,757 |
1,465 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,422 |
2,054 |
$0.00 |
| 92551 |
|
297 |
259 |
$0.00 |
| 81001 |
|
17 |
13 |
$0.00 |
| 36416 |
|
867 |
717 |
$0.00 |
| 96127 |
|
618 |
453 |
$0.00 |
| 90674 |
|
289 |
253 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
49 |
37 |
$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 |
69 |
62 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
28 |
24 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
83 |
68 |
$0.00 |
| 81005 |
|
15 |
12 |
$0.00 |