| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
40 |
37 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
1,460 |
1,383 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
778 |
722 |
$0.00 |
| 90651 |
|
66 |
65 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,985 |
15,309 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
350 |
318 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
734 |
707 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
856 |
823 |
$0.00 |
| 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 |
1,554 |
1,144 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
455 |
448 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
992 |
693 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
219 |
214 |
$0.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
415 |
390 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
490 |
476 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
117 |
117 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,412 |
871 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
12 |
12 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
80 |
80 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
99 |
68 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
229 |
128 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
238 |
206 |
$0.00 |
| D2331 |
|
40 |
26 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
68 |
67 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
14 |
14 |
$0.00 |
| 98967 |
|
39 |
33 |
$0.00 |
| 90686 |
|
21 |
21 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
16 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
513 |
506 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
2,752 |
2,545 |
$0.00 |
| 81002 |
|
57 |
54 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
326 |
233 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,114 |
1,086 |
$0.00 |
| 98968 |
|
292 |
166 |
$0.00 |
| D1110 |
Prophylaxis - adult |
1,293 |
1,261 |
$0.00 |
| 99499 |
|
205 |
193 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,934 |
1,340 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
343 |
292 |
$0.00 |
| 80061 |
Lipid panel |
105 |
105 |
$0.00 |
| 87631 |
|
500 |
482 |
$0.00 |
| 81025 |
|
26 |
25 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
376 |
364 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
226 |
116 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
511 |
304 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
44 |
$0.00 |
| 90734 |
|
53 |
53 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
20 |
$0.00 |
| 81003 |
|
17 |
16 |
$0.00 |
| 90715 |
|
40 |
40 |
$0.00 |
| D1120 |
Prophylaxis - child |
118 |
117 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
39 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
44 |
44 |
$0.00 |
| 99348 |
|
39 |
24 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$0.00 |
| D4910 |
|
12 |
12 |
$0.00 |