| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
54,701 |
37,151 |
$9.47M |
| T1016 |
Case management, each 15 minutes |
3,409 |
3,002 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,754 |
13,573 |
$6K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
10,963 |
5,529 |
$5K |
| H0031 |
Mental health assessment, by non-physician |
466 |
446 |
$950.87 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,960 |
1,810 |
$912.17 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,528 |
2,246 |
$715.04 |
| 97802 |
|
1,057 |
973 |
$571.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,507 |
1,374 |
$555.96 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
542 |
444 |
$421.85 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
63 |
61 |
$360.32 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
70 |
65 |
$300.84 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,728 |
2,459 |
$294.45 |
| 0054A |
|
84 |
81 |
$249.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,078 |
961 |
$170.64 |
| 97803 |
|
410 |
365 |
$130.56 |
| 99442 |
|
178 |
141 |
$81.76 |
| 90715 |
|
229 |
211 |
$64.72 |
| 90474 |
|
40 |
40 |
$42.66 |
| 96150 |
|
162 |
127 |
$19.79 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
30 |
29 |
$14.51 |
| 81002 |
|
98 |
94 |
$6.96 |
| D0270 |
|
332 |
288 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
2,173 |
1,989 |
$0.00 |
| D0330 |
Panoramic radiographic image |
112 |
103 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,066 |
1,018 |
$0.00 |
| D1321 |
|
52 |
52 |
$0.00 |
| D1354 |
|
274 |
70 |
$0.00 |
| 90670 |
|
91 |
88 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
151 |
112 |
$0.00 |
| 81025 |
|
106 |
98 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
422 |
408 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$0.00 |
| D1110 |
Prophylaxis - adult |
98 |
93 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
63 |
60 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
191 |
179 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
293 |
244 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
356 |
237 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
26 |
$0.00 |
| 96156 |
|
794 |
684 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
184 |
129 |
$0.00 |
| D1351 |
Sealant - per tooth |
170 |
58 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,381 |
1,846 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,586 |
1,495 |
$0.00 |
| 90686 |
|
1,024 |
931 |
$0.00 |
| D1310 |
|
763 |
702 |
$0.00 |
| D1330 |
|
762 |
703 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,059 |
1,463 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
1,691 |
1,333 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
819 |
790 |
$0.00 |
| D0601 |
|
63 |
61 |
$0.00 |
| D9995 |
|
454 |
442 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
124 |
117 |
$0.00 |
| D1320 |
|
198 |
194 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
30 |
24 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
33 |
31 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
355 |
347 |
$0.00 |
| 99441 |
|
63 |
42 |
$0.00 |
| 96127 |
|
14 |
13 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
171 |
166 |
$0.00 |
| 90732 |
|
18 |
14 |
$0.00 |
| D0602 |
|
71 |
67 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
18 |
12 |
$0.00 |
| D0603 |
|
35 |
35 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 99381 |
|
14 |
13 |
$0.00 |