| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,734 |
3,171 |
$1.38M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,449 |
1,251 |
$582K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,009 |
574 |
$534K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
708 |
404 |
$283K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
336 |
243 |
$130K |
| 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 |
1,776 |
1,486 |
$76K |
| 90834 |
Psychotherapy, 45 minutes with patient |
120 |
69 |
$72K |
| 90832 |
Psychotherapy, 30 minutes with patient |
82 |
42 |
$42K |
| 96127 |
|
66 |
58 |
$30K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
76 |
70 |
$20K |
| D1110 |
Prophylaxis - adult |
78 |
58 |
$14K |
| D0220 |
Intraoral - periapical first radiographic image |
178 |
159 |
$6K |
| D0274 |
Bitewings - four radiographic images |
50 |
43 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
13 |
12 |
$2K |
| 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 |
28 |
28 |
$408.24 |
| 80305 |
|
17 |
13 |
$0.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
25 |
14 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
29 |
16 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
24 |
24 |
$0.00 |