| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
76,207 |
62,986 |
$7.33M |
| D1110 |
Prophylaxis - adult |
491 |
481 |
$18K |
| D0140 |
Limited oral evaluation - problem focused |
368 |
347 |
$12K |
| D0330 |
Panoramic radiographic image |
363 |
342 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
289 |
270 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
300 |
300 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
47 |
37 |
$1K |
| D1120 |
Prophylaxis - child |
27 |
27 |
$1K |
| D0274 |
Bitewings - four radiographic images |
28 |
28 |
$828.17 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,568 |
40,669 |
$504.48 |
| D0220 |
Intraoral - periapical first radiographic image |
26 |
26 |
$144.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,956 |
1,561 |
$99.45 |
| 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 |
15,426 |
7,381 |
$88.86 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,795 |
5,509 |
$18.09 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,271 |
5,094 |
$0.00 |
| 91301 |
|
986 |
963 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
3,079 |
2,746 |
$0.00 |
| 82962 |
|
3,528 |
2,860 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
394 |
324 |
$0.00 |
| 86580 |
|
264 |
253 |
$0.00 |
| 90688 |
|
2,306 |
1,876 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
925 |
517 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,485 |
1,309 |
$0.00 |
| 92551 |
|
787 |
756 |
$0.00 |
| 99000 |
|
399 |
384 |
$0.00 |
| 0011A |
|
432 |
427 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,620 |
919 |
$0.00 |
| 96127 |
|
226 |
213 |
$0.00 |
| 90686 |
|
770 |
678 |
$0.00 |
| 91200 |
|
168 |
132 |
$0.00 |
| 0012A |
|
459 |
453 |
$0.00 |
| 90732 |
|
51 |
38 |
$0.00 |
| 0064A |
|
119 |
109 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
31 |
30 |
$0.00 |
| D9995 |
|
122 |
113 |
$0.00 |
| 90651 |
|
70 |
63 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
55 |
27 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |
| D5899 |
|
14 |
13 |
$0.00 |
| 91306 |
|
50 |
49 |
$0.00 |
| 90474 |
|
15 |
15 |
$0.00 |
| 90647 |
|
19 |
19 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
32 |
25 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 83986 |
|
17 |
17 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
15 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
20 |
13 |
$0.00 |
| 81025 |
|
2,283 |
2,179 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
987 |
923 |
$0.00 |
| 11721 |
|
1,392 |
1,136 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,177 |
4,349 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
726 |
547 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
485 |
452 |
$0.00 |
| 11056 |
|
284 |
246 |
$0.00 |
| 81002 |
|
2,674 |
2,249 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
427 |
395 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
213 |
209 |
$0.00 |
| 87210 |
|
811 |
526 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
523 |
482 |
$0.00 |
| 99173 |
|
844 |
816 |
$0.00 |
| 90715 |
|
347 |
328 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
362 |
330 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
862 |
583 |
$0.00 |
| D0191 |
|
98 |
97 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
97 |
78 |
$0.00 |
| 86703 |
|
220 |
200 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
504 |
482 |
$0.00 |
| D2999 |
|
339 |
300 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
301 |
243 |
$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 |
224 |
106 |
$0.00 |
| 90670 |
|
262 |
199 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
263 |
256 |
$0.00 |
| 91313 |
|
13 |
12 |
$0.00 |
| D0190 |
|
73 |
66 |
$0.00 |
| 99201 |
|
134 |
128 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90633 |
|
21 |
21 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90734 |
|
42 |
32 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
44 |
27 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |