| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
14,350 |
12,206 |
$2.97M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30,283 |
27,642 |
$1.43M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26,310 |
24,030 |
$1.40M |
| 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 |
12,558 |
9,688 |
$128K |
| 80305 |
|
6,883 |
5,997 |
$75K |
| 90688 |
|
552 |
540 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
649 |
639 |
$6K |
| 0011A |
|
146 |
146 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
164 |
162 |
$4K |
| 90756 |
|
287 |
285 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
106 |
79 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
41 |
41 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
94 |
94 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
100 |
100 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
58 |
24 |
$2K |
| D1110 |
Prophylaxis - adult |
40 |
39 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
554 |
533 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
15 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
17 |
13 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$960.42 |
| D4341 |
|
34 |
26 |
$797.94 |
| D0220 |
Intraoral - periapical first radiographic image |
92 |
90 |
$606.76 |
| D1206 |
Topical application of fluoride varnish |
46 |
46 |
$582.23 |
| 0012A |
|
16 |
16 |
$532.00 |
| 99215 |
Prolong outpt/office vis |
14 |
12 |
$473.07 |
| 90715 |
|
12 |
12 |
$340.45 |
| 90686 |
|
30 |
30 |
$265.19 |
| 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 |
17 |
16 |
$74.43 |
| 81025 |
|
14 |
13 |
$59.50 |
| 3079F |
|
80 |
76 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
59 |
55 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
341 |
332 |
$0.00 |
| 3075F |
|
14 |
13 |
$0.00 |
| 3074F |
|
527 |
477 |
$0.00 |
| 91301 |
|
158 |
158 |
$0.00 |
| 0064A |
|
16 |
16 |
$0.00 |
| 1036F |
|
12 |
12 |
$0.00 |
| 3078F |
|
357 |
324 |
$0.00 |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
12 |
12 |
$0.00 |