| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,648 |
7,907 |
$883K |
| D0999 |
Unspecified diagnostic procedure, by report |
3,488 |
3,102 |
$502K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,062 |
3,728 |
$186K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,069 |
1,930 |
$108K |
| 90837 |
Psychotherapy, 53 minutes with patient |
963 |
689 |
$79K |
| 87428 |
|
705 |
673 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
131 |
127 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
64 |
64 |
$5K |
| 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 |
84 |
77 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
327 |
318 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
42 |
39 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
24 |
24 |
$2K |
| 99215 |
Prolong outpt/office vis |
16 |
16 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
15 |
12 |
$875.08 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
24 |
22 |
$497.53 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
132 |
113 |
$212.37 |
| 80305 |
|
66 |
57 |
$179.86 |
| 81025 |
|
52 |
40 |
$173.52 |
| D1120 |
Prophylaxis - child |
825 |
794 |
$147.00 |
| D1206 |
Topical application of fluoride varnish |
1,116 |
1,067 |
$58.80 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$33.43 |
| D0220 |
Intraoral - periapical first radiographic image |
359 |
313 |
$27.56 |
| 81002 |
|
14 |
14 |
$23.36 |
| D0145 |
Oral evaluation for a patient under three years of age |
102 |
89 |
$0.00 |
| D1110 |
Prophylaxis - adult |
83 |
82 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
22 |
15 |
$0.00 |
| D1999 |
|
257 |
235 |
$0.00 |
| D0330 |
Panoramic radiographic image |
15 |
13 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
70 |
69 |
$0.00 |
| D0603 |
|
587 |
565 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
23 |
12 |
$0.00 |
| D0602 |
|
289 |
283 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
33 |
31 |
$0.00 |
| D1310 |
|
29 |
28 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
141 |
130 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
33 |
31 |
$0.00 |
| D1351 |
Sealant - per tooth |
129 |
26 |
$0.00 |
| 90733 |
|
19 |
19 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
14 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15 |
15 |
$0.00 |