| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
66,565 |
8,991 |
$36.72M |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
8,070 |
4,161 |
$610K |
| 96165 |
|
21,040 |
3,363 |
$523K |
| 96164 |
|
21,292 |
3,385 |
$462K |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
19,889 |
1,274 |
$377K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,995 |
1,730 |
$136K |
| H0001 |
Alcohol and/or drug assessment |
808 |
791 |
$115K |
| 90837 |
Psychotherapy, 53 minutes with patient |
821 |
449 |
$78K |
| H0033 |
Oral medication administration, direct observation |
5,168 |
387 |
$64K |
| 80305 |
|
2,673 |
1,642 |
$36K |
| D7140 |
Extraction, erupted tooth or exposed root |
528 |
166 |
$29K |
| H0038 |
Self-help/peer services, per 15 minutes |
299 |
171 |
$18K |
| T1017 |
Targeted case management, each 15 minutes |
448 |
248 |
$17K |
| J3490 |
Unclassified drugs |
125 |
101 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
145 |
145 |
$7K |
| D0330 |
Panoramic radiographic image |
194 |
192 |
$5K |
| 99205 |
Prolong outpt/office vis |
39 |
38 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
123 |
119 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
82 |
65 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58 |
47 |
$3K |
| 99215 |
Prolong outpt/office vis |
18 |
17 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
78 |
78 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
14 |
14 |
$2K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
20 |
12 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
12 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
57 |
56 |
$717.42 |
| D1206 |
Topical application of fluoride varnish |
16 |
16 |
$295.68 |
| D0350 |
|
100 |
100 |
$0.00 |