| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
33,030 |
20,272 |
$2.14M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
20,710 |
12,021 |
$677K |
| 90834 |
Psychotherapy, 45 minutes with patient |
9,405 |
2,665 |
$254K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,996 |
3,873 |
$144K |
| D1110 |
Prophylaxis - adult |
1,285 |
799 |
$29K |
| 90837 |
Psychotherapy, 53 minutes with patient |
754 |
169 |
$24K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
604 |
288 |
$22K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
166 |
93 |
$14K |
| D0210 |
Intraoral - complete series of radiographic images |
371 |
237 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,330 |
831 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
599 |
363 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
222 |
118 |
$8K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
240 |
172 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,393 |
573 |
$8K |
| 91320 |
|
88 |
59 |
$7K |
| D0120 |
Periodic oral evaluation - established patient |
450 |
279 |
$6K |
| 90686 |
|
340 |
207 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
37 |
25 |
$3K |
| 90480 |
|
87 |
59 |
$3K |
| D0274 |
Bitewings - four radiographic images |
212 |
131 |
$2K |
| 90674 |
|
144 |
82 |
$2K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
185 |
44 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
108 |
54 |
$1K |
| D0330 |
Panoramic radiographic image |
110 |
68 |
$1K |
| 90656 |
|
71 |
60 |
$962.11 |
| D0140 |
Limited oral evaluation - problem focused |
93 |
55 |
$883.10 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
32 |
15 |
$750.88 |
| 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 |
33 |
26 |
$706.84 |
| 90658 |
|
90 |
56 |
$415.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22 |
12 |
$267.30 |
| 80305 |
|
30 |
13 |
$101.00 |
| 1034F |
|
800 |
547 |
$0.00 |
| 1036F |
|
3,043 |
2,203 |
$0.00 |
| 3008F |
|
14,389 |
8,705 |
$0.00 |
| 3079F |
|
2,725 |
2,029 |
$0.00 |
| 3074F |
|
7,716 |
6,046 |
$0.00 |
| 99000 |
|
323 |
230 |
$0.00 |
| 3080F |
|
122 |
93 |
$0.00 |
| 3075F |
|
260 |
189 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
23 |
13 |
$0.00 |
| 90611 |
|
151 |
66 |
$0.00 |
| 3078F |
|
5,356 |
4,153 |
$0.00 |
| 3077F |
|
100 |
64 |
$0.00 |