| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
23,287 |
16,782 |
$6.91M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,267 |
2,633 |
$104K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,424 |
1,196 |
$37K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,333 |
945 |
$21K |
| 96156 |
|
238 |
208 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
91 |
75 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46 |
41 |
$706.44 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
63 |
52 |
$445.69 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
32 |
32 |
$166.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
41 |
28 |
$87.95 |
| D1206 |
Topical application of fluoride varnish |
81 |
74 |
$82.00 |
| 87428 |
|
86 |
75 |
$73.49 |
| D0220 |
Intraoral - periapical first radiographic image |
32 |
32 |
$54.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
15 |
15 |
$24.36 |
| D0190 |
|
181 |
161 |
$0.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
17 |
15 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
47 |
16 |
$0.00 |