| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
1,073 |
910 |
$342K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
967 |
727 |
$185K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
738 |
558 |
$141K |
| 36415 |
Collection of venous blood by venipuncture |
493 |
375 |
$13K |
| 90832 |
Psychotherapy, 30 minutes with patient |
116 |
59 |
$12K |
| 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 |
206 |
130 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
58 |
44 |
$11K |
| 90837 |
Psychotherapy, 53 minutes with patient |
125 |
51 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
49 |
31 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
19 |
15 |
$3K |
| 96127 |
|
781 |
559 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
27 |
13 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
485 |
344 |
$431.83 |
| D0140 |
Limited oral evaluation - problem focused |
94 |
93 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
91 |
91 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
73 |
62 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
115 |
115 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
15 |
12 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
13 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
98 |
98 |
$0.00 |
| D1110 |
Prophylaxis - adult |
194 |
194 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
39 |
28 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
111 |
109 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
133 |
133 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
156 |
104 |
$0.00 |
| D0330 |
Panoramic radiographic image |
15 |
15 |
$0.00 |