| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,870 |
6,113 |
$207K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,248 |
2,132 |
$66K |
| T1015 |
Clinic visit/encounter, all-inclusive |
448 |
366 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
287 |
251 |
$22K |
| 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 |
885 |
635 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
256 |
215 |
$20K |
| 90834 |
Psychotherapy, 45 minutes with patient |
437 |
341 |
$19K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
491 |
297 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
644 |
566 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
92 |
75 |
$7K |
| 90791 |
Psychiatric diagnostic evaluation |
222 |
166 |
$6K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
66 |
46 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
332 |
313 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
831 |
686 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
199 |
187 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
176 |
100 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
357 |
313 |
$3K |
| 92551 |
|
663 |
594 |
$3K |
| D1110 |
Prophylaxis - adult |
211 |
198 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
245 |
238 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
281 |
238 |
$2K |
| D0330 |
Panoramic radiographic image |
100 |
93 |
$2K |
| D0274 |
Bitewings - four radiographic images |
155 |
146 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
172 |
169 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
189 |
176 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
44 |
29 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
83 |
73 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
171 |
132 |
$1K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
13 |
13 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
263 |
255 |
$814.95 |
| D1208 |
Topical application of fluoride, excluding varnish |
144 |
126 |
$738.87 |
| 99173 |
|
622 |
573 |
$447.05 |
| 90649 |
|
147 |
142 |
$344.89 |
| 90658 |
|
37 |
35 |
$232.30 |
| 90651 |
|
86 |
84 |
$214.32 |
| 83026 |
|
95 |
85 |
$205.16 |
| 81002 |
|
279 |
188 |
$133.44 |
| 81025 |
|
31 |
26 |
$106.42 |
| 90734 |
|
106 |
100 |
$105.60 |
| D1120 |
Prophylaxis - child |
49 |
42 |
$103.50 |
| 90863 |
|
109 |
99 |
$101.23 |
| 90633 |
|
111 |
108 |
$56.76 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
14 |
13 |
$55.50 |
| 82962 |
|
176 |
159 |
$29.62 |
| 90686 |
|
174 |
171 |
$16.87 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
121 |
108 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
44 |
37 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
12 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |
| 80061 |
Lipid panel |
17 |
14 |
$0.00 |