| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
121,399 |
106,755 |
$18.40M |
| 00003 |
Internal/system code - not a standard HCPCS code |
21,240 |
17,238 |
$3.77M |
| 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 |
14,647 |
10,161 |
$202K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56,234 |
41,932 |
$161K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,472 |
1,608 |
$100K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,656 |
1,736 |
$99K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37,991 |
29,838 |
$67K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,537 |
1,085 |
$65K |
| 59425 |
|
682 |
484 |
$47K |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,404 |
3,558 |
$42K |
| 92551 |
|
6,213 |
4,466 |
$42K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,359 |
990 |
$39K |
| 90686 |
|
4,990 |
3,909 |
$32K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,035 |
4,786 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,355 |
10,370 |
$13K |
| 99173 |
|
6,465 |
4,688 |
$13K |
| 90670 |
|
1,738 |
1,214 |
$12K |
| 87428 |
|
469 |
325 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
951 |
710 |
$10K |
| 90791 |
Psychiatric diagnostic evaluation |
793 |
678 |
$10K |
| 90837 |
Psychotherapy, 53 minutes with patient |
319 |
253 |
$10K |
| 90834 |
Psychotherapy, 45 minutes with patient |
506 |
435 |
$7K |
| G9012 |
Other specified case management service not elsewhere classified |
135 |
78 |
$7K |
| 85018 |
|
11,680 |
8,984 |
$7K |
| 90715 |
|
1,147 |
970 |
$7K |
| 90633 |
|
810 |
536 |
$6K |
| 90750 |
|
118 |
89 |
$6K |
| 90723 |
|
991 |
679 |
$6K |
| 90651 |
|
654 |
457 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
337 |
307 |
$5K |
| 90648 |
|
607 |
380 |
$4K |
| 90734 |
|
526 |
369 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
898 |
798 |
$4K |
| 90647 |
|
578 |
426 |
$3K |
| 81003 |
|
7,017 |
4,804 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,195 |
1,015 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,117 |
2,951 |
$2K |
| 90620 |
|
126 |
90 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
554 |
385 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
511 |
457 |
$1K |
| 90681 |
|
206 |
141 |
$1K |
| 90710 |
|
106 |
66 |
$972.00 |
| 99381 |
|
58 |
51 |
$951.84 |
| 99384 |
|
32 |
26 |
$920.85 |
| 81025 |
|
649 |
440 |
$694.27 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
846 |
643 |
$664.09 |
| 90696 |
|
63 |
37 |
$630.00 |
| 90716 |
|
66 |
41 |
$551.55 |
| 99383 |
|
44 |
40 |
$438.60 |
| 90677 |
|
77 |
74 |
$424.62 |
| 90707 |
|
41 |
27 |
$396.79 |
| 99385 |
|
247 |
210 |
$376.53 |
| 90700 |
|
44 |
24 |
$294.27 |
| 90662 |
|
563 |
562 |
$245.83 |
| 82948 |
|
413 |
312 |
$243.33 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
90 |
77 |
$93.86 |
| 99215 |
Prolong outpt/office vis |
86 |
77 |
$85.80 |
| 82247 |
|
123 |
68 |
$73.46 |
| 83655 |
|
44 |
39 |
$63.78 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
403 |
401 |
$41.16 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
23 |
13 |
$18.00 |
| D1206 |
Topical application of fluoride varnish |
737 |
736 |
$18.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
116 |
108 |
$8.00 |
| 3077F |
|
409 |
338 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
853 |
624 |
$0.00 |
| 3078F |
|
1,817 |
1,368 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,388 |
2,375 |
$0.00 |
| D0270 |
|
170 |
169 |
$0.00 |
| 3051F |
|
16 |
12 |
$0.00 |
| D1110 |
Prophylaxis - adult |
85 |
85 |
$0.00 |
| D4341 |
|
332 |
184 |
$0.00 |
| G9920 |
Screening performed and negative |
27 |
27 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
864 |
850 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
223 |
223 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
283 |
276 |
$0.00 |
| D9430 |
|
642 |
554 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
1,541 |
1,478 |
$0.00 |
| Z6400 |
|
103 |
100 |
$0.00 |
| D1120 |
Prophylaxis - child |
391 |
390 |
$0.00 |
| 87400 |
|
43 |
42 |
$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 |
33 |
31 |
$0.00 |
| 3008F |
|
2,107 |
2,015 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
236 |
236 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
369 |
366 |
$0.00 |
| Z1034 |
|
3,464 |
2,442 |
$0.00 |
| 3351F |
|
198 |
194 |
$0.00 |
| 1111F |
|
899 |
867 |
$0.00 |
| 3079F |
|
612 |
490 |
$0.00 |
| D0603 |
|
859 |
859 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
1,698 |
1,618 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,647 |
548 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
436 |
435 |
$0.00 |
| 3044F |
|
38 |
29 |
$0.00 |
| 3074F |
|
1,856 |
1,399 |
$0.00 |
| G0443 |
Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
12 |
12 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
58 |
58 |
$0.00 |
| 99386 |
|
56 |
56 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
786 |
786 |
$0.00 |
| 2001F |
|
1,880 |
1,790 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
366 |
366 |
$0.00 |
| 1034F |
|
57 |
47 |
$0.00 |
| 3075F |
|
331 |
260 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
289 |
261 |
$0.00 |
| 1036F |
|
1,946 |
1,479 |
$0.00 |
| D2330 |
|
14 |
12 |
$0.00 |
| 3080F |
|
131 |
108 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
38 |
38 |
$0.00 |
| 82962 |
|
34 |
33 |
$0.00 |
| Z1038 |
|
12 |
12 |
$0.00 |
| D1330 |
|
13 |
13 |
$0.00 |
| 90474 |
|
12 |
12 |
$0.00 |