| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
19,805 |
16,259 |
$3.67M |
| 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 |
2,286 |
2,079 |
$145K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,182 |
659 |
$111K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,954 |
6,333 |
$97K |
| 90832 |
Psychotherapy, 30 minutes with patient |
522 |
350 |
$43K |
| D0140 |
Limited oral evaluation - problem focused |
2,773 |
2,684 |
$38K |
| D0120 |
Periodic oral evaluation - established patient |
1,177 |
1,149 |
$24K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,422 |
856 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,007 |
1,848 |
$19K |
| D1120 |
Prophylaxis - child |
2,089 |
2,029 |
$18K |
| D0330 |
Panoramic radiographic image |
1,282 |
1,264 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
2,313 |
2,243 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
882 |
871 |
$12K |
| D0274 |
Bitewings - four radiographic images |
1,199 |
1,168 |
$9K |
| D0270 |
|
1,196 |
1,176 |
$7K |
| D1206 |
Topical application of fluoride varnish |
2,906 |
2,793 |
$6K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
205 |
157 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
47 |
45 |
$3K |
| D1351 |
Sealant - per tooth |
1,912 |
398 |
$3K |
| D1110 |
Prophylaxis - adult |
811 |
784 |
$3K |
| 11721 |
|
447 |
441 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
170 |
157 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
58 |
58 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
381 |
370 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
687 |
657 |
$1K |
| D0272 |
Bitewings - two radiographic images |
400 |
393 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
40 |
$1K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
206 |
161 |
$1K |
| D9910 |
|
21 |
16 |
$965.44 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
59 |
59 |
$662.29 |
| 90791 |
Psychiatric diagnostic evaluation |
112 |
108 |
$598.37 |
| 90837 |
Psychotherapy, 53 minutes with patient |
63 |
42 |
$547.75 |
| D2940 |
|
135 |
63 |
$193.39 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$186.36 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32 |
32 |
$179.52 |
| D0230 |
Intraoral - periapical each additional radiographic image |
144 |
109 |
$81.55 |
| 90686 |
|
57 |
56 |
$48.78 |
| D1330 |
|
129 |
124 |
$17.34 |
| D0603 |
|
550 |
530 |
$0.02 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
66 |
65 |
$0.00 |
| 90674 |
|
12 |
12 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
48 |
48 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
63 |
63 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
25 |
25 |
$0.00 |