| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
34,870 |
20,659 |
$9.26M |
| T1016 |
Case management, each 15 minutes |
564 |
315 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,815 |
2,942 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,726 |
10,780 |
$3K |
| 99215 |
Prolong outpt/office vis |
82 |
55 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
175 |
90 |
$1K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
7,448 |
2,848 |
$1K |
| 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 |
683 |
475 |
$826.80 |
| 0012A |
|
207 |
176 |
$120.00 |
| 0002A |
|
59 |
59 |
$40.00 |
| 0001A |
|
53 |
53 |
$40.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
158 |
142 |
$30.86 |
| 99000 |
|
2,145 |
1,904 |
$19.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,508 |
1,371 |
$2.55 |
| D0220 |
Intraoral - periapical first radiographic image |
254 |
178 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
169 |
147 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
968 |
840 |
$0.00 |
| 3078F |
|
915 |
820 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
45 |
44 |
$0.00 |
| 91300 |
|
104 |
94 |
$0.00 |
| 0013A |
|
94 |
90 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
111 |
104 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
174 |
150 |
$0.00 |
| 1003F |
|
93 |
64 |
$0.00 |
| 0071A |
|
29 |
28 |
$0.00 |
| 1158F |
|
72 |
54 |
$0.00 |
| 4004F |
|
48 |
39 |
$0.00 |
| 3077F |
|
15 |
15 |
$0.00 |
| 82948 |
|
26 |
13 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
41 |
$0.00 |
| 99173 |
|
38 |
38 |
$0.00 |
| 90621 |
|
16 |
15 |
$0.00 |
| D1120 |
Prophylaxis - child |
14 |
14 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
14 |
$0.00 |
| 3075F |
|
191 |
179 |
$0.00 |
| 1220F |
|
3,034 |
2,446 |
$0.00 |
| 3079F |
|
316 |
282 |
$0.00 |
| 91301 |
|
460 |
393 |
$0.00 |
| 1036F |
|
1,774 |
1,438 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$0.00 |
| 90686 |
|
187 |
175 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
26 |
13 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
107 |
100 |
$0.00 |
| 0011A |
|
198 |
178 |
$0.00 |
| 3074F |
|
949 |
852 |
$0.00 |
| 96127 |
|
35 |
32 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13 |
12 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
58 |
36 |
$0.00 |
| 1126F |
|
110 |
87 |
$0.00 |
| 1125F |
|
79 |
59 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
37 |
25 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
103 |
$0.00 |
| 0072A |
|
18 |
18 |
$0.00 |
| 90651 |
|
29 |
25 |
$0.00 |
| 91303 |
|
19 |
15 |
$0.00 |
| 0031A |
|
34 |
26 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
19 |
17 |
$0.00 |
| 91307 |
|
23 |
21 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
25 |
12 |
$0.00 |