| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
1,608 |
1,524 |
$1.10M |
| 90837 |
Psychotherapy, 53 minutes with patient |
256 |
164 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48 |
46 |
$32K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
17 |
$13K |
| 90834 |
Psychotherapy, 45 minutes with patient |
62 |
51 |
$12K |
| D1110 |
Prophylaxis - adult |
87 |
71 |
$10K |
| 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 |
28 |
12 |
$8K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
30 |
24 |
$2K |
| 98968 |
|
52 |
25 |
$2K |
| D1206 |
Topical application of fluoride varnish |
69 |
65 |
$1K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
161 |
157 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
30 |
25 |
$948.90 |
| D1120 |
Prophylaxis - child |
20 |
17 |
$654.00 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
25 |
25 |
$0.00 |