| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
59,403 |
51,987 |
$15.08M |
| 99239 |
Hospital discharge day management, more than 30 minutes |
40 |
40 |
$3K |
| 59025 |
Fetal non-stress test |
132 |
91 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
27 |
27 |
$1K |
| 99460 |
|
12 |
12 |
$852.47 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,555 |
2,283 |
$525.12 |
| 99462 |
|
14 |
12 |
$416.78 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,764 |
10,371 |
$194.69 |
| 90832 |
Psychotherapy, 30 minutes with patient |
361 |
294 |
$145.74 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
29 |
29 |
$136.50 |
| D0120 |
Periodic oral evaluation - established patient |
529 |
520 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
964 |
937 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
2,055 |
1,308 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
4,084 |
4,038 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
3,165 |
3,042 |
$0.00 |
| D1330 |
|
648 |
643 |
$0.00 |
| D0603 |
|
2,066 |
2,042 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
65 |
54 |
$0.00 |
| 99000 |
|
110 |
104 |
$0.00 |
| 1111F |
|
1,380 |
1,278 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,288 |
975 |
$0.00 |
| 3008F |
|
330 |
294 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
162 |
126 |
$0.00 |
| NOMIN |
Inj roctavian ml 2x10^13vc g |
36 |
30 |
$0.00 |
| D0602 |
|
259 |
256 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
108 |
105 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
413 |
299 |
$0.00 |
| 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 |
16 |
14 |
$0.00 |
| 91306 |
|
12 |
12 |
$0.00 |
| D1351 |
Sealant - per tooth |
81 |
24 |
$0.00 |
| 91301 |
|
30 |
14 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
31 |
28 |
$0.00 |
| 90686 |
|
93 |
81 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$0.00 |
| D0601 |
|
13 |
12 |
$0.00 |
| D9995 |
|
12 |
12 |
$0.00 |
| 0011A |
|
16 |
14 |
$0.00 |
| 3074F |
|
15 |
12 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
4,262 |
4,059 |
$0.00 |
| D1120 |
Prophylaxis - child |
755 |
751 |
$0.00 |
| 1160F |
|
1,970 |
1,823 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
111 |
82 |
$0.00 |
| D0190 |
|
2,502 |
2,486 |
$0.00 |
| 99442 |
|
54 |
51 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
405 |
400 |
$0.00 |
| D1354 |
|
433 |
123 |
$0.00 |
| D0270 |
|
83 |
82 |
$0.00 |
| D1110 |
Prophylaxis - adult |
694 |
678 |
$0.00 |
| 1159F |
|
1,819 |
1,685 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
141 |
126 |
$0.00 |
| D0330 |
Panoramic radiographic image |
517 |
512 |
$0.00 |
| 96158 |
|
479 |
362 |
$0.00 |
| 96159 |
|
276 |
213 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
70 |
63 |
$0.00 |
| D9993 |
|
286 |
284 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
34 |
19 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
14 |
13 |
$0.00 |