| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
320,109 |
259,305 |
$31.78M |
| 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 |
386,266 |
302,191 |
$16.02M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
103,909 |
82,404 |
$131K |
| D0120 |
Periodic oral evaluation - established patient |
3,772 |
3,672 |
$94K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,557 |
3,465 |
$73K |
| D1120 |
Prophylaxis - child |
1,443 |
1,420 |
$64K |
| D1110 |
Prophylaxis - adult |
1,160 |
1,146 |
$41K |
| D0140 |
Limited oral evaluation - problem focused |
778 |
754 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
11,744 |
7,251 |
$14K |
| D0330 |
Panoramic radiographic image |
556 |
554 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,047 |
3,910 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16,276 |
13,232 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,192 |
18,199 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,611 |
4,492 |
$5K |
| D0274 |
Bitewings - four radiographic images |
374 |
368 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
64 |
63 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,253 |
3,867 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,901 |
1,813 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
19 |
13 |
$2K |
| D0272 |
Bitewings - two radiographic images |
46 |
46 |
$2K |
| 11721 |
|
6,059 |
5,720 |
$1K |
| D1206 |
Topical application of fluoride varnish |
82 |
82 |
$1K |
| 99381 |
|
679 |
587 |
$1K |
| 0012A |
|
1,574 |
1,516 |
$925.17 |
| 0011A |
|
1,361 |
1,321 |
$814.10 |
| 92551 |
|
7,910 |
7,765 |
$618.50 |
| 90670 |
|
2,202 |
1,861 |
$577.94 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
11,553 |
7,543 |
$550.27 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23,365 |
22,682 |
$532.75 |
| D0191 |
|
1,793 |
1,746 |
$380.72 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
7,274 |
7,016 |
$371.29 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
215 |
193 |
$354.88 |
| 82962 |
|
10,491 |
8,291 |
$319.90 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,483 |
1,442 |
$235.50 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
432 |
381 |
$226.32 |
| 81025 |
|
4,404 |
4,170 |
$197.44 |
| 90746 |
|
196 |
169 |
$189.90 |
| 96127 |
|
4,910 |
4,752 |
$160.39 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,273 |
2,992 |
$155.04 |
| 90688 |
|
6,668 |
5,763 |
$149.35 |
| 99173 |
|
6,378 |
6,223 |
$147.35 |
| 0064A |
|
607 |
597 |
$120.00 |
| 0072A |
|
111 |
108 |
$120.00 |
| 81002 |
|
4,693 |
3,889 |
$101.94 |
| 0071A |
|
114 |
110 |
$80.00 |
| 90474 |
|
1,763 |
1,661 |
$79.25 |
| 90715 |
|
1,420 |
1,362 |
$74.34 |
| 90732 |
|
172 |
139 |
$72.71 |
| D0220 |
Intraoral - periapical first radiographic image |
136 |
130 |
$64.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,317 |
1,184 |
$60.72 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,187 |
1,852 |
$52.47 |
| 99201 |
|
345 |
295 |
$46.65 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
795 |
762 |
$39.42 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$31.09 |
| 86703 |
|
246 |
242 |
$26.90 |
| 86580 |
|
340 |
316 |
$15.13 |
| 90619 |
|
362 |
361 |
$11.00 |
| 87210 |
|
351 |
228 |
$9.26 |
| 99000 |
|
842 |
772 |
$7.36 |
| 96161 |
|
1,961 |
1,836 |
$2.77 |
| 90680 |
|
1,715 |
1,502 |
$0.03 |
| 90647 |
|
1,864 |
1,750 |
$0.03 |
| 90723 |
|
1,837 |
1,725 |
$0.03 |
| 90686 |
|
5,978 |
5,835 |
$0.01 |
| 91307 |
|
167 |
166 |
$0.01 |
| D0999 |
Unspecified diagnostic procedure, by report |
6,850 |
6,332 |
$0.00 |
| 91301 |
|
2,118 |
2,007 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
1,808 |
1,067 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
75 |
55 |
$0.00 |
| 93000 |
|
732 |
685 |
$0.00 |
| 90696 |
|
250 |
248 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,140 |
690 |
$0.00 |
| 90651 |
|
824 |
811 |
$0.00 |
| 92250 |
|
70 |
67 |
$0.00 |
| 0134A |
|
101 |
99 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
413 |
214 |
$0.00 |
| 91306 |
|
359 |
352 |
$0.00 |
| 90716 |
|
194 |
194 |
$0.00 |
| 90677 |
|
895 |
853 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
269 |
267 |
$0.00 |
| D5899 |
|
131 |
92 |
$0.00 |
| T2022 |
Case management, per month |
2,004 |
1,997 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$0.00 |
| D9995 |
|
165 |
147 |
$0.00 |
| 90480 |
|
195 |
193 |
$0.00 |
| 91303 |
|
40 |
40 |
$0.00 |
| 98925 |
|
13 |
12 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
16 |
12 |
$0.00 |
| 90620 |
|
144 |
144 |
$0.00 |
| M0201 |
Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
29 |
29 |
$0.00 |
| 91318 |
|
18 |
18 |
$0.00 |
| 90656 |
|
39 |
39 |
$0.00 |
| 83986 |
|
16 |
16 |
$0.00 |
| 0031A |
|
40 |
40 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
18 |
18 |
$0.00 |
| 91305 |
|
13 |
13 |
$0.00 |
| 90750 |
|
266 |
262 |
$0.00 |
| 90685 |
|
350 |
344 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
49 |
$0.00 |
| 11056 |
|
702 |
689 |
$0.00 |
| 90633 |
|
1,125 |
1,103 |
$0.00 |
| 90672 |
|
82 |
82 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
522 |
515 |
$0.00 |
| 90710 |
|
469 |
461 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
620 |
592 |
$0.00 |
| D2999 |
|
269 |
245 |
$0.00 |
| 97803 |
|
88 |
88 |
$0.00 |
| 90700 |
|
234 |
232 |
$0.00 |
| 90707 |
|
198 |
198 |
$0.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
114 |
93 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
73 |
53 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
51 |
51 |
$0.00 |
| 91322 |
|
25 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
430 |
426 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
143 |
118 |
$0.00 |
| 90649 |
|
29 |
25 |
$0.00 |
| 90461 |
|
73 |
72 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
60 |
50 |
$0.00 |
| 99442 |
|
33 |
29 |
$0.00 |
| T2023 |
Targeted case management; per month |
18 |
18 |
$0.00 |
| 91313 |
|
49 |
47 |
$0.00 |
| 90734 |
|
55 |
50 |
$0.00 |
| 90473 |
|
153 |
150 |
$0.00 |
| 91300 |
|
67 |
59 |
$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 |
447 |
228 |
$0.00 |
| 0073A |
|
33 |
33 |
$0.00 |
| 11720 |
|
12 |
12 |
$0.00 |