| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
12,667 |
9,053 |
$2.03M |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,164 |
572 |
$642.70 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,634 |
1,454 |
$537.54 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,219 |
2,769 |
$340.12 |
| D0140 |
Limited oral evaluation - problem focused |
1,561 |
1,318 |
$279.64 |
| D0220 |
Intraoral - periapical first radiographic image |
1,788 |
1,517 |
$106.12 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
44 |
35 |
$75.95 |
| 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 |
62 |
49 |
$73.18 |
| 96152 |
|
563 |
234 |
$18.21 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
12 |
$0.00 |
| 90686 |
|
202 |
187 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
215 |
203 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
372 |
242 |
$0.00 |
| 1220F |
|
12 |
12 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
65 |
40 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
16 |
15 |
$0.00 |
| 97803 |
|
168 |
151 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
60 |
57 |
$0.00 |
| D2954 |
|
61 |
56 |
$0.00 |
| 81002 |
|
69 |
65 |
$0.00 |
| 82947 |
|
48 |
40 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
31 |
29 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
13 |
13 |
$0.00 |
| D1120 |
Prophylaxis - child |
16 |
14 |
$0.00 |
| D2740 |
Crown - porcelain/ceramic |
74 |
68 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
16 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
13 |
12 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
16 |
14 |
$0.00 |
| 90756 |
|
17 |
16 |
$0.00 |