| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
2,713 |
1,861 |
$738K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,511 |
1,189 |
$192K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
651 |
454 |
$66K |
| 90837 |
Psychotherapy, 53 minutes with patient |
186 |
88 |
$27K |
| D1110 |
Prophylaxis - adult |
413 |
341 |
$20K |
| 36415 |
Collection of venous blood by venipuncture |
151 |
125 |
$14K |
| D0120 |
Periodic oral evaluation - established patient |
434 |
355 |
$11K |
| D0140 |
Limited oral evaluation - problem focused |
179 |
171 |
$9K |
| 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 |
195 |
158 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
110 |
107 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
239 |
224 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
24 |
12 |
$2K |
| D0274 |
Bitewings - four radiographic images |
42 |
36 |
$549.00 |