| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,309 |
6,497 |
$538K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,556 |
2,195 |
$76K |
| 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 |
7,630 |
5,396 |
$41K |
| 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 |
1,413 |
1,163 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
182 |
128 |
$9K |
| D0999 |
Unspecified diagnostic procedure, by report |
53 |
48 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
232 |
140 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
37 |
23 |
$3K |
| 99382 |
|
19 |
19 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
16 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
14 |
$2K |
| D1351 |
Sealant - per tooth |
87 |
31 |
$919.86 |
| 36415 |
Collection of venous blood by venipuncture |
1,212 |
833 |
$608.34 |
| D1120 |
Prophylaxis - child |
58 |
54 |
$459.93 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
13 |
$320.46 |
| D1206 |
Topical application of fluoride varnish |
250 |
139 |
$306.62 |
| 92567 |
|
61 |
58 |
$145.33 |
| 0011A |
|
37 |
36 |
$135.20 |
| 82947 |
|
653 |
446 |
$127.44 |
| 82962 |
|
63 |
50 |
$56.05 |
| 3074F |
|
817 |
666 |
$0.00 |
| 3079F |
|
244 |
207 |
$0.00 |
| 1126F |
|
720 |
621 |
$0.00 |
| 1125F |
|
609 |
510 |
$0.00 |
| 3008F |
|
937 |
789 |
$0.00 |
| 85018 |
|
136 |
111 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
19 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
26 |
$0.00 |
| D0601 |
|
166 |
50 |
$0.00 |
| 3075F |
|
14 |
13 |
$0.00 |
| 1160F |
|
1,615 |
1,363 |
$0.00 |
| 3078F |
|
822 |
673 |
$0.00 |
| 1159F |
|
1,603 |
1,355 |
$0.00 |
| 3288F |
|
123 |
107 |
$0.00 |
| 90756 |
|
69 |
45 |
$0.00 |
| 3725F |
|
187 |
160 |
$0.00 |
| D0190 |
|
51 |
33 |
$0.00 |
| 3077F |
|
62 |
58 |
$0.00 |
| 99490 |
Ccm add 20min |
107 |
107 |
$0.00 |
| 99173 |
|
67 |
58 |
$0.00 |
| 11721 |
|
31 |
24 |
$0.00 |