| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
36,197 |
18,973 |
$6.91M |
| 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 |
2,733 |
1,792 |
$162K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,549 |
1,926 |
$132K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,016 |
8,337 |
$82K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,188 |
8,756 |
$70K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,999 |
1,740 |
$24K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,187 |
743 |
$17K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
282 |
195 |
$7K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
138 |
121 |
$5K |
| 0031A |
|
135 |
135 |
$5K |
| 99000 |
|
1,158 |
861 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
334 |
296 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
268 |
136 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
304 |
275 |
$2K |
| 0064A |
|
86 |
68 |
$2K |
| 91322 |
|
13 |
13 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
706 |
645 |
$2K |
| 0011A |
|
34 |
34 |
$1K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
26 |
25 |
$1K |
| 0124A |
|
27 |
27 |
$898.19 |
| 0012A |
|
25 |
25 |
$894.96 |
| 99215 |
Prolong outpt/office vis |
131 |
115 |
$881.72 |
| D0220 |
Intraoral - periapical first radiographic image |
599 |
559 |
$864.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
479 |
453 |
$701.82 |
| 90480 |
|
14 |
14 |
$547.54 |
| D0330 |
Panoramic radiographic image |
294 |
282 |
$514.59 |
| 0034A |
|
13 |
13 |
$447.48 |
| D1110 |
Prophylaxis - adult |
157 |
151 |
$439.65 |
| D0274 |
Bitewings - four radiographic images |
293 |
283 |
$359.94 |
| 91306 |
|
81 |
66 |
$199.44 |
| D7140 |
Extraction, erupted tooth or exposed root |
373 |
202 |
$147.75 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
133 |
127 |
$119.99 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
66 |
65 |
$97.92 |
| D0120 |
Periodic oral evaluation - established patient |
84 |
82 |
$45.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
658 |
629 |
$27.00 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$23.87 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
63 |
56 |
$22.68 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
32 |
25 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
17 |
$0.00 |
| 91312 |
|
27 |
26 |
$0.00 |
| 91303 |
|
153 |
149 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |
| 91301 |
|
59 |
59 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
197 |
193 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
12 |
$0.00 |