| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,348 |
5,904 |
$828K |
| D0999 |
Unspecified diagnostic procedure, by report |
8,251 |
4,938 |
$686K |
| H2020 |
Therapeutic behavioral services, per diem |
6,856 |
3,750 |
$573K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,806 |
1,235 |
$963.70 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,249 |
1,470 |
$712.66 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,067 |
4,498 |
$507.91 |
| D1110 |
Prophylaxis - adult |
1,053 |
735 |
$189.16 |
| D0220 |
Intraoral - periapical first radiographic image |
574 |
360 |
$144.70 |
| D0274 |
Bitewings - four radiographic images |
1,042 |
716 |
$102.00 |
| D0120 |
Periodic oral evaluation - established patient |
508 |
386 |
$80.49 |
| D0210 |
Intraoral - complete series of radiographic images |
59 |
29 |
$59.27 |
| D0330 |
Panoramic radiographic image |
1,166 |
794 |
$0.36 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
5,196 |
2,081 |
$0.00 |
| D1330 |
|
699 |
517 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
533 |
405 |
$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 |
382 |
324 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
482 |
368 |
$0.00 |
| 99406 |
|
208 |
159 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
139 |
85 |
$0.00 |
| D0603 |
|
968 |
711 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
464 |
354 |
$0.00 |
| 97802 |
|
343 |
237 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
19 |
13 |
$0.00 |
| 81000 |
|
211 |
170 |
$0.00 |
| 85018 |
|
20 |
12 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
214 |
176 |
$0.00 |
| 82962 |
|
22 |
14 |
$0.00 |
| D0602 |
|
71 |
51 |
$0.00 |
| D0601 |
|
17 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
81 |
66 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
74 |
53 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
29 |
12 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
21 |
14 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12 |
12 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
56 |
27 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,377 |
840 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
1,979 |
901 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
1,332 |
914 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
336 |
284 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
32 |
28 |
$0.00 |
| D1999 |
|
13 |
13 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,048 |
907 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
77 |
64 |
$0.00 |
| 90661 |
|
113 |
66 |
$0.00 |
| 81025 |
|
18 |
12 |
$0.00 |
| D0270 |
|
55 |
40 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
19 |
18 |
$0.00 |
| 90658 |
|
46 |
37 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
18 |
18 |
$0.00 |