| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
15,144 |
12,277 |
$4.51M |
| T1015 |
Clinic visit/encounter, all-inclusive |
5,560 |
4,506 |
$1.13M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,008 |
4,602 |
$1.06M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,512 |
2,787 |
$584K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,456 |
950 |
$542K |
| 90834 |
Psychotherapy, 45 minutes with patient |
760 |
459 |
$147K |
| D1110 |
Prophylaxis - adult |
2,139 |
1,970 |
$60K |
| 90832 |
Psychotherapy, 30 minutes with patient |
360 |
116 |
$43K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
185 |
113 |
$36K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
651 |
602 |
$20K |
| D1206 |
Topical application of fluoride varnish |
671 |
528 |
$18K |
| D0274 |
Bitewings - four radiographic images |
803 |
726 |
$16K |
| D0190 |
|
454 |
337 |
$15K |
| D0350 |
|
149 |
122 |
$10K |
| H0031 |
Mental health assessment, by non-physician |
38 |
14 |
$8K |
| D0120 |
Periodic oral evaluation - established patient |
2,005 |
1,951 |
$7K |
| D1120 |
Prophylaxis - child |
99 |
84 |
$7K |
| D0240 |
|
121 |
97 |
$4K |
| 0012A |
|
123 |
114 |
$4K |
| 0001A |
|
105 |
95 |
$4K |
| 0002A |
|
91 |
79 |
$4K |
| D1351 |
Sealant - per tooth |
64 |
13 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
145 |
130 |
$4K |
| 0011A |
|
119 |
115 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
13 |
12 |
$3K |
| 90480 |
|
68 |
64 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
208 |
187 |
$3K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
285 |
181 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
244 |
185 |
$2K |
| 99173 |
|
172 |
138 |
$2K |
| 90688 |
|
84 |
66 |
$2K |
| 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 |
58 |
37 |
$2K |
| T1017 |
Targeted case management, each 15 minutes |
27 |
15 |
$1K |
| 0031A |
|
30 |
30 |
$1K |
| 99429 |
|
17 |
12 |
$507.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
646 |
503 |
$488.60 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
223 |
150 |
$431.31 |
| 36415 |
Collection of venous blood by venipuncture |
899 |
693 |
$317.61 |
| 90682 |
|
13 |
13 |
$252.42 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
17 |
16 |
$51.31 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
97 |
66 |
$47.85 |
| D0220 |
Intraoral - periapical first radiographic image |
155 |
154 |
$30.00 |
| 91320 |
|
39 |
34 |
$24.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16 |
15 |
$6.59 |
| 96127 |
|
53 |
41 |
$0.00 |
| 97802 |
|
54 |
47 |
$0.00 |
| 90698 |
|
21 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
83 |
62 |
$0.00 |
| 90677 |
|
25 |
25 |
$0.00 |
| D4910 |
|
70 |
70 |
$0.00 |
| 90461 |
|
63 |
40 |
$0.00 |
| 90658 |
|
18 |
17 |
$0.00 |
| 90670 |
|
25 |
14 |
$0.00 |
| 90687 |
|
22 |
12 |
$0.00 |
| 81025 |
|
18 |
12 |
$0.00 |