| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
22,898 |
11,988 |
$705K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,909 |
5,134 |
$419K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,481 |
3,708 |
$379K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,702 |
2,724 |
$266K |
| D9999 |
Unspecified adjunctive procedure, by report |
5,468 |
3,711 |
$234K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,388 |
808 |
$158K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,382 |
769 |
$44K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,115 |
841 |
$35K |
| D0210 |
Intraoral - complete series of radiographic images |
642 |
459 |
$32K |
| 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 |
1,041 |
748 |
$23K |
| D0140 |
Limited oral evaluation - problem focused |
626 |
455 |
$20K |
| D1110 |
Prophylaxis - adult |
420 |
300 |
$17K |
| 80305 |
|
1,589 |
899 |
$16K |
| D7140 |
Extraction, erupted tooth or exposed root |
191 |
72 |
$14K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
132 |
92 |
$8K |
| 99215 |
Prolong outpt/office vis |
70 |
35 |
$8K |
| 90791 |
Psychiatric diagnostic evaluation |
80 |
38 |
$8K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,308 |
868 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
89 |
50 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
374 |
270 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
57 |
38 |
$4K |
| D0330 |
Panoramic radiographic image |
130 |
99 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
188 |
135 |
$4K |
| 90837 |
Psychotherapy, 53 minutes with patient |
38 |
26 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
35 |
17 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
232 |
152 |
$4K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
57 |
37 |
$2K |
| 99385 |
|
29 |
13 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
132 |
32 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
109 |
58 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
47 |
30 |
$428.22 |
| D0274 |
Bitewings - four radiographic images |
13 |
13 |
$326.38 |
| D1206 |
Topical application of fluoride varnish |
13 |
12 |
$185.36 |
| 36415 |
Collection of venous blood by venipuncture |
52 |
40 |
$179.85 |
| 81003 |
|
22 |
14 |
$51.89 |