| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
27,056 |
23,074 |
$5.17M |
| H2019 |
Therapeutic behavioral services, per 15 minutes |
3,238 |
1,003 |
$153K |
| H0032 |
Mental health service plan development by non-physician |
794 |
263 |
$119K |
| 0012A |
|
140 |
140 |
$5K |
| 0011A |
|
146 |
144 |
$5K |
| H2021 |
Community-based wrap-around services, per 15 minutes |
57 |
12 |
$4K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
213 |
159 |
$3K |
| 0002A |
|
62 |
61 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,165 |
7,179 |
$2K |
| 0064A |
|
49 |
49 |
$2K |
| 0001A |
|
45 |
45 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,985 |
2,732 |
$2K |
| 3077F |
|
443 |
417 |
$1K |
| 3074F |
|
341 |
331 |
$1K |
| 3079F |
|
310 |
304 |
$884.78 |
| 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 |
13 |
13 |
$725.30 |
| 3078F |
|
228 |
221 |
$650.20 |
| 3080F |
|
294 |
280 |
$371.01 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,625 |
2,354 |
$263.74 |
| 3075F |
|
96 |
93 |
$215.38 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
444 |
414 |
$95.00 |
| 99173 |
|
1,093 |
1,025 |
$30.00 |
| 92551 |
|
701 |
654 |
$16.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
227 |
214 |
$9.83 |
| 81000 |
|
14 |
12 |
$8.64 |
| 81025 |
|
517 |
483 |
$4.00 |
| D0603 |
|
79 |
78 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
745 |
720 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
33 |
33 |
$0.00 |
| D1330 |
|
101 |
101 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
57 |
57 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
147 |
146 |
$0.00 |
| 91301 |
|
33 |
33 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
202 |
185 |
$0.00 |
| 90686 |
|
188 |
183 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
274 |
272 |
$0.00 |
| 11721 |
|
180 |
179 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
101 |
101 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
134 |
100 |
$0.00 |
| D9110 |
|
26 |
26 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
424 |
233 |
$0.00 |
| 91300 |
|
18 |
17 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
145 |
139 |
$0.00 |
| D1110 |
Prophylaxis - adult |
17 |
17 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 0502F |
|
17 |
12 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
35 |
29 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
43 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 80061 |
Lipid panel |
52 |
40 |
$0.00 |
| 90715 |
|
29 |
29 |
$0.00 |
| 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 |
74 |
68 |
$0.00 |
| 90461 |
|
19 |
14 |
$0.00 |