| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
5,814 |
4,081 |
$1.65M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,620 |
5,123 |
$1.10M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,977 |
1,260 |
$287K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,557 |
803 |
$110K |
| 90837 |
Psychotherapy, 53 minutes with patient |
537 |
116 |
$54K |
| 36415 |
Collection of venous blood by venipuncture |
939 |
637 |
$32K |
| D1110 |
Prophylaxis - adult |
576 |
497 |
$16K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
211 |
124 |
$10K |
| 90832 |
Psychotherapy, 30 minutes with patient |
135 |
79 |
$10K |
| 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 |
265 |
136 |
$7K |
| 90834 |
Psychotherapy, 45 minutes with patient |
43 |
14 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
236 |
223 |
$6K |
| 96127 |
|
1,934 |
1,045 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
34 |
30 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
401 |
343 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
47 |
25 |
$5K |
| D1206 |
Topical application of fluoride varnish |
479 |
415 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
155 |
119 |
$3K |
| D0274 |
Bitewings - four radiographic images |
227 |
191 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
211 |
166 |
$2K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
77 |
66 |
$800.00 |
| D1120 |
Prophylaxis - child |
22 |
13 |
$720.00 |
| 90686 |
|
26 |
20 |
$660.67 |
| 99406 |
|
18 |
12 |
$338.22 |
| 0011A |
|
16 |
16 |
$272.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
14 |
$261.15 |
| 3074F |
|
185 |
138 |
$216.89 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
124 |
111 |
$19.27 |
| 3078F |
|
168 |
127 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
13 |
13 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
16 |
15 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
18 |
14 |
$0.00 |
| 97802 |
|
62 |
55 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
16 |
12 |
$0.00 |
| 91301 |
|
16 |
16 |
$0.00 |