| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
43,614 |
24,063 |
$3.02M |
| H2020 |
Therapeutic behavioral services, per diem |
12,565 |
4,036 |
$662K |
| D0999 |
Unspecified diagnostic procedure, by report |
6,321 |
4,075 |
$395K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,793 |
803 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,585 |
1,231 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,493 |
13,035 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
1,409 |
1,054 |
$3K |
| D1110 |
Prophylaxis - adult |
538 |
435 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
995 |
761 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,061 |
4,119 |
$1K |
| D0274 |
Bitewings - four radiographic images |
152 |
140 |
$1K |
| D0272 |
Bitewings - two radiographic images |
762 |
648 |
$959.02 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,000 |
397 |
$925.60 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,457 |
3,798 |
$676.65 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
47 |
40 |
$246.42 |
| D0330 |
Panoramic radiographic image |
264 |
191 |
$154.46 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
4,482 |
679 |
$114.90 |
| 0064A |
|
106 |
67 |
$100.68 |
| 91306 |
|
85 |
61 |
$62.08 |
| 97161 |
|
290 |
182 |
$58.94 |
| 0011A |
|
95 |
82 |
$37.08 |
| 97014 |
|
401 |
71 |
$20.47 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
171 |
116 |
$12.36 |
| 90791 |
Psychiatric diagnostic evaluation |
538 |
358 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
8,999 |
3,011 |
$0.00 |
| D1999 |
|
119 |
118 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
795 |
551 |
$0.00 |
| D1120 |
Prophylaxis - child |
786 |
719 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
277 |
195 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
29 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
103 |
70 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
245 |
41 |
$0.00 |
| 92552 |
|
117 |
58 |
$0.00 |
| 11721 |
|
17 |
17 |
$0.00 |
| 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 |
46 |
28 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
33 |
29 |
$0.00 |
| 81003 |
|
56 |
42 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
14 |
$0.00 |
| 99201 |
|
13 |
12 |
$0.00 |
| D1330 |
|
113 |
86 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,811 |
1,380 |
$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 |
2,542 |
1,880 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
342 |
299 |
$0.00 |
| 97010 |
|
3,167 |
570 |
$0.00 |
| 90674 |
|
88 |
62 |
$0.00 |
| 99384 |
|
84 |
64 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
187 |
145 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
799 |
739 |
$0.00 |
| 00000 |
|
24 |
13 |
$0.00 |
| 85018 |
|
168 |
84 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
334 |
246 |
$0.00 |
| 99441 |
|
166 |
140 |
$0.00 |
| 91301 |
|
266 |
201 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
37 |
36 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
141 |
92 |
$0.00 |
| 0012A |
|
106 |
91 |
$0.00 |
| 90686 |
|
110 |
101 |
$0.00 |
| 99383 |
|
60 |
49 |
$0.00 |
| 81005 |
|
158 |
76 |
$0.00 |
| 92283 |
|
91 |
59 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
33 |
28 |
$0.00 |
| 82962 |
|
31 |
16 |
$0.00 |
| 97032 |
|
188 |
68 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
24 |
14 |
$0.00 |
| 97035 |
|
108 |
12 |
$0.00 |
| 96127 |
|
16 |
14 |
$0.00 |