| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90832 |
Psychotherapy, 30 minutes with patient |
2,847 |
1,563 |
$108K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,907 |
1,051 |
$106K |
| 90837 |
Psychotherapy, 53 minutes with patient |
868 |
492 |
$69K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
1,634 |
729 |
$39K |
| D1120 |
Prophylaxis - child |
750 |
710 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
367 |
330 |
$18K |
| 90791 |
Psychiatric diagnostic evaluation |
205 |
192 |
$18K |
| 99401 |
|
322 |
291 |
$11K |
| D1206 |
Topical application of fluoride varnish |
414 |
393 |
$11K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
127 |
63 |
$10K |
| 96127 |
|
877 |
834 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
301 |
279 |
$9K |
| D0602 |
|
342 |
325 |
$7K |
| D1208 |
Topical application of fluoride, excluding varnish |
278 |
262 |
$6K |
| D0274 |
Bitewings - four radiographic images |
155 |
143 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
123 |
110 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
29 |
13 |
$2K |
| D1351 |
Sealant - per tooth |
149 |
29 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
34 |
30 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
101 |
99 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
51 |
47 |
$963.24 |
| D0603 |
|
35 |
31 |
$540.96 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
33 |
33 |
$364.40 |
| D0272 |
Bitewings - two radiographic images |
18 |
18 |
$313.60 |
| D0601 |
|
15 |
12 |
$247.94 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$209.04 |
| 99411 |
|
19 |
17 |
$188.28 |
| 90686 |
|
80 |
60 |
$114.94 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
14 |
$0.00 |