| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,976 |
1,661 |
$412K |
| 90832 |
Psychotherapy, 30 minutes with patient |
728 |
408 |
$167K |
| D1206 |
Topical application of fluoride varnish |
774 |
763 |
$120K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
624 |
529 |
$111K |
| 90834 |
Psychotherapy, 45 minutes with patient |
77 |
57 |
$29K |
| D9410 |
|
93 |
92 |
$19K |
| D0140 |
Limited oral evaluation - problem focused |
73 |
73 |
$15K |
| D1351 |
Sealant - per tooth |
209 |
56 |
$8K |
| D1120 |
Prophylaxis - child |
516 |
508 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
28 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
26 |
$5K |
| D1110 |
Prophylaxis - adult |
159 |
158 |
$769.41 |
| 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 |
61 |
38 |
$138.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
15 |
$0.00 |