| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
130,465 |
112,983 |
$28.50M |
| 0012A |
|
1,412 |
1,349 |
$47K |
| 0011A |
|
1,627 |
1,522 |
$45K |
| 0001A |
|
1,051 |
1,008 |
$38K |
| 0002A |
|
988 |
942 |
$38K |
| 0071A |
|
811 |
801 |
$28K |
| 0072A |
|
477 |
476 |
$18K |
| 90480 |
|
545 |
525 |
$13K |
| 0064A |
|
336 |
314 |
$13K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,251 |
931 |
$12K |
| 99499 |
|
406 |
385 |
$10K |
| 0124A |
|
285 |
284 |
$8K |
| 0053A |
|
169 |
168 |
$6K |
| 0052A |
|
131 |
131 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
33,492 |
30,085 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,129 |
8,962 |
$4K |
| 0051A |
|
118 |
117 |
$4K |
| 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 |
425 |
346 |
$4K |
| 0081A |
|
149 |
147 |
$3K |
| 0003A |
|
91 |
83 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,657 |
3,504 |
$3K |
| 0031A |
|
79 |
79 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,073 |
13,049 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12,377 |
11,861 |
$2K |
| 0004A |
|
42 |
42 |
$2K |
| 0054A |
|
41 |
41 |
$1K |
| 0154A |
|
63 |
61 |
$1K |
| 0074A |
|
37 |
37 |
$960.00 |
| 0082A |
|
31 |
30 |
$720.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,402 |
4,191 |
$702.15 |
| 92551 |
|
8,677 |
8,280 |
$537.26 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,663 |
3,555 |
$411.84 |
| 0013A |
|
13 |
13 |
$400.00 |
| 0134A |
|
12 |
12 |
$360.00 |
| 90461 |
|
4,438 |
4,316 |
$140.02 |
| 90686 |
|
6,010 |
5,567 |
$136.17 |
| 99173 |
|
8,893 |
8,495 |
$135.04 |
| 90656 |
|
486 |
486 |
$134.10 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
8,016 |
7,689 |
$99.35 |
| 36415 |
Collection of venous blood by venipuncture |
16,619 |
15,760 |
$61.08 |
| D1110 |
Prophylaxis - adult |
1,077 |
1,042 |
$36.00 |
| 96127 |
|
4,713 |
4,429 |
$33.00 |
| D0120 |
Periodic oral evaluation - established patient |
2,249 |
2,201 |
$20.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,225 |
2,081 |
$18.00 |
| D0220 |
Intraoral - periapical first radiographic image |
311 |
310 |
$16.00 |
| 91320 |
|
257 |
255 |
$10.00 |
| 90647 |
|
1,609 |
1,570 |
$0.00 |
| 90723 |
|
1,584 |
1,537 |
$0.00 |
| D0603 |
|
1,573 |
1,572 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
827 |
772 |
$0.00 |
| 82607 |
|
583 |
566 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
190 |
184 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
661 |
656 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
97 |
97 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
2,019 |
2,008 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,455 |
1,419 |
$0.00 |
| D1310 |
|
549 |
547 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
376 |
363 |
$0.00 |
| 90696 |
|
358 |
341 |
$0.00 |
| 90716 |
|
554 |
539 |
$0.00 |
| D1330 |
|
1,346 |
1,335 |
$0.00 |
| 99381 |
|
59 |
54 |
$0.00 |
| 99383 |
|
13 |
13 |
$0.00 |
| 90620 |
|
649 |
617 |
$0.00 |
| 90677 |
|
370 |
369 |
$0.00 |
| 90651 |
|
1,475 |
1,420 |
$0.00 |
| D0601 |
|
127 |
127 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
177 |
138 |
$0.00 |
| 91319 |
|
105 |
102 |
$0.00 |
| D1351 |
Sealant - per tooth |
297 |
65 |
$0.00 |
| 82746 |
|
579 |
562 |
$0.00 |
| 99000 |
|
127 |
125 |
$0.00 |
| D0602 |
|
67 |
67 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
63 |
60 |
$0.00 |
| 91301 |
|
18 |
17 |
$0.00 |
| 91318 |
|
57 |
57 |
$0.00 |
| 81000 |
|
12 |
12 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
372 |
285 |
$0.00 |
| 11721 |
|
1,214 |
1,180 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,617 |
2,520 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
7,996 |
7,647 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
136 |
131 |
$0.00 |
| 90681 |
|
733 |
710 |
$0.00 |
| 83655 |
|
1,157 |
1,110 |
$0.00 |
| 90633 |
|
1,410 |
1,376 |
$0.00 |
| 82948 |
|
1,163 |
1,040 |
$0.00 |
| 11056 |
|
515 |
468 |
$0.00 |
| D0330 |
Panoramic radiographic image |
451 |
445 |
$0.00 |
| 90710 |
|
387 |
368 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,933 |
1,812 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
486 |
467 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
819 |
809 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
55 |
55 |
$0.00 |
| 90670 |
|
1,709 |
1,652 |
$0.00 |
| 90700 |
|
358 |
342 |
$0.00 |
| 90715 |
|
645 |
621 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
2,018 |
2,007 |
$0.00 |
| 90707 |
|
459 |
445 |
$0.00 |
| D9110 |
|
166 |
164 |
$0.00 |
| 90734 |
|
1,167 |
1,121 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
113 |
113 |
$0.00 |
| 99382 |
|
12 |
12 |
$0.00 |
| D1120 |
Prophylaxis - child |
1,199 |
1,169 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
54 |
53 |
$0.00 |
| 99497 |
|
13 |
13 |
$0.00 |
| D0270 |
|
13 |
13 |
$0.00 |
| 99442 |
|
25 |
25 |
$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 |
13 |
13 |
$0.00 |
| 90713 |
|
13 |
13 |
$0.00 |
| 82565 |
|
13 |
13 |
$0.00 |
| 90750 |
|
15 |
15 |
$0.00 |
| 90662 |
|
14 |
12 |
$0.00 |
| 11719 |
|
12 |
12 |
$0.00 |
| D1999 |
|
26 |
26 |
$0.00 |
| 11057 |
|
12 |
12 |
$0.00 |