| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,535 |
6,152 |
$1.06M |
| D0999 |
Unspecified diagnostic procedure, by report |
2,647 |
2,102 |
$608K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
3,414 |
1,718 |
$503K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,327 |
1,919 |
$391K |
| H0031 |
Mental health assessment, by non-physician |
1,041 |
434 |
$166K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,039 |
543 |
$116K |
| 90834 |
Psychotherapy, 45 minutes with patient |
403 |
273 |
$55K |
| H0023 |
Behavioral health outreach service (planned approach to reach a targeted population) |
259 |
105 |
$38K |
| 90791 |
Psychiatric diagnostic evaluation |
209 |
200 |
$33K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
251 |
100 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
126 |
118 |
$20K |
| D1110 |
Prophylaxis - adult |
374 |
365 |
$15K |
| 99215 |
Prolong outpt/office vis |
39 |
29 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
605 |
581 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
41 |
36 |
$4K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,940 |
1,524 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
20 |
14 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
13 |
12 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
219 |
219 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
72 |
71 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
25 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
40 |
40 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
263 |
261 |
$874.00 |
| D0274 |
Bitewings - four radiographic images |
92 |
91 |
$715.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
73 |
71 |
$619.74 |
| 97810 |
|
856 |
567 |
$601.29 |
| 99000 |
|
132 |
123 |
$404.48 |
| 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 |
14 |
12 |
$308.07 |
| 36415 |
Collection of venous blood by venipuncture |
467 |
424 |
$191.55 |
| D1206 |
Topical application of fluoride varnish |
429 |
392 |
$150.00 |
| D0330 |
Panoramic radiographic image |
16 |
15 |
$125.00 |
| 90686 |
|
14 |
14 |
$0.00 |
| 98926 |
|
468 |
354 |
$0.00 |
| 81003 |
|
34 |
28 |
$0.00 |
| 97811 |
|
79 |
49 |
$0.00 |