| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
103,108 |
80,801 |
$26.08M |
| 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 |
2,659 |
2,077 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
661 |
645 |
$551.43 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,143 |
2,092 |
$381.35 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
121 |
108 |
$268.67 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,447 |
18,809 |
$263.01 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,842 |
2,573 |
$178.00 |
| 99215 |
Prolong outpt/office vis |
1,292 |
1,166 |
$101.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,406 |
7,142 |
$60.24 |
| 85018 |
|
769 |
739 |
$44.70 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,746 |
3,666 |
$34.27 |
| 81025 |
|
1,822 |
1,678 |
$25.67 |
| 99000 |
|
1,317 |
1,234 |
$23.56 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
654 |
575 |
$22.65 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
103 |
96 |
$19.89 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
561 |
552 |
$18.59 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
596 |
555 |
$18.37 |
| 83655 |
|
318 |
308 |
$17.50 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,589 |
15,105 |
$9.27 |
| 1160F |
|
8,361 |
7,146 |
$1.65 |
| 1159F |
|
8,321 |
7,101 |
$1.65 |
| 3008F |
|
9,301 |
7,739 |
$1.65 |
| 1111F |
|
8,196 |
6,994 |
$1.65 |
| 3074F |
|
7,780 |
6,424 |
$1.32 |
| 3078F |
|
6,290 |
5,240 |
$0.66 |
| 90686 |
|
2,740 |
2,651 |
$0.66 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,369 |
1,288 |
$0.33 |
| 81003 |
|
2,226 |
2,063 |
$0.33 |
| 90647 |
|
1,282 |
1,250 |
$0.33 |
| 3075F |
|
914 |
859 |
$0.33 |
| 3079F |
|
2,529 |
2,305 |
$0.33 |
| 90473 |
|
923 |
909 |
$0.00 |
| D1120 |
Prophylaxis - child |
489 |
487 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
3,861 |
3,179 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
501 |
478 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,132 |
1,090 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
726 |
612 |
$0.00 |
| 90685 |
|
570 |
552 |
$0.00 |
| 90715 |
|
796 |
773 |
$0.00 |
| D0330 |
Panoramic radiographic image |
354 |
335 |
$0.00 |
| 90670 |
|
1,635 |
1,587 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,745 |
1,671 |
$0.00 |
| D1110 |
Prophylaxis - adult |
1,430 |
996 |
$0.00 |
| 81002 |
|
440 |
394 |
$0.00 |
| 99173 |
|
1,487 |
1,424 |
$0.00 |
| D0190 |
|
2,907 |
2,871 |
$0.00 |
| 90633 |
|
436 |
423 |
$0.00 |
| 3077F |
|
295 |
278 |
$0.00 |
| D0270 |
|
178 |
174 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
719 |
476 |
$0.00 |
| 99188 |
|
731 |
718 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
524 |
494 |
$0.00 |
| 59025 |
Fetal non-stress test |
85 |
45 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
348 |
330 |
$0.00 |
| 91322 |
|
80 |
80 |
$0.00 |
| 1158F |
|
157 |
148 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
325 |
313 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
211 |
204 |
$0.00 |
| 99177 |
|
264 |
253 |
$0.00 |
| 90681 |
|
154 |
150 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
30 |
28 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
453 |
436 |
$0.00 |
| 80305 |
|
188 |
165 |
$0.00 |
| D9993 |
|
524 |
520 |
$0.00 |
| D1354 |
|
645 |
143 |
$0.00 |
| 90734 |
|
45 |
43 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
14 |
14 |
$0.00 |
| 90671 |
|
129 |
129 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
243 |
174 |
$0.00 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
27 |
27 |
$0.00 |
| 90700 |
|
28 |
26 |
$0.00 |
| 90707 |
|
67 |
64 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
12 |
$0.00 |
| 90662 |
|
20 |
18 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
22 |
22 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
41 |
12 |
$0.00 |
| 3080F |
|
158 |
148 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
650 |
634 |
$0.00 |
| 90696 |
|
26 |
26 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,827 |
1,041 |
$0.00 |
| 87807 |
|
16 |
16 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
4,136 |
3,900 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,916 |
1,086 |
$0.00 |
| 90677 |
|
131 |
130 |
$0.00 |
| 90723 |
|
1,404 |
1,375 |
$0.00 |
| D0603 |
|
2,625 |
2,554 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
716 |
620 |
$0.00 |
| D1330 |
|
1,330 |
1,305 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
35 |
24 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
917 |
776 |
$0.00 |
| 90680 |
|
631 |
618 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
2,631 |
2,185 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
19 |
14 |
$0.00 |
| D0602 |
|
329 |
319 |
$0.00 |
| 92551 |
|
705 |
669 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
62 |
54 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
71 |
71 |
$0.00 |
| 0012A |
|
209 |
175 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
416 |
294 |
$0.00 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
45 |
42 |
$0.00 |
| 90651 |
|
226 |
219 |
$0.00 |
| 90716 |
|
79 |
75 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
136 |
73 |
$0.00 |
| 90480 |
|
39 |
39 |
$0.00 |
| 3048F |
|
72 |
69 |
$0.00 |
| 59430 |
|
124 |
121 |
$0.00 |
| D1351 |
Sealant - per tooth |
200 |
62 |
$0.00 |
| 91301 |
|
698 |
363 |
$0.00 |
| 0011A |
|
167 |
151 |
$0.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
96 |
84 |
$0.00 |
| 99381 |
|
37 |
37 |
$0.00 |
| 0064A |
|
12 |
12 |
$0.00 |
| D0601 |
|
17 |
17 |
$0.00 |
| 90656 |
|
163 |
163 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
34 |
30 |
$0.00 |
| 1126F |
|
81 |
74 |
$0.00 |
| D9994 |
|
32 |
31 |
$0.00 |
| 88720 |
|
13 |
12 |
$0.00 |
| 3044F |
|
60 |
50 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
16 |
12 |
$0.00 |
| 91306 |
|
12 |
12 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
12 |
$0.00 |
| 99172 |
|
46 |
46 |
$0.00 |