| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
102,730 |
68,557 |
$17.26M |
| 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 |
73,257 |
43,357 |
$5.26M |
| T2023 |
Targeted case management; per month |
2,783 |
1,971 |
$265K |
| T2022 |
Case management, per month |
2,854 |
1,862 |
$199K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
5,858 |
1,580 |
$87K |
| D1110 |
Prophylaxis - adult |
1,742 |
1,597 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30,497 |
21,726 |
$23K |
| D0120 |
Periodic oral evaluation - established patient |
1,488 |
1,413 |
$20K |
| D0274 |
Bitewings - four radiographic images |
1,257 |
1,200 |
$19K |
| 97803 |
|
854 |
662 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,476 |
16,427 |
$18K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,325 |
1,232 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
1,452 |
1,291 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
328 |
302 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
16,664 |
6,116 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
738 |
640 |
$4K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
19,786 |
5,738 |
$4K |
| D0330 |
Panoramic radiographic image |
299 |
268 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
270 |
217 |
$1K |
| D4910 |
|
141 |
141 |
$980.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
6,071 |
1,376 |
$832.83 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,948 |
1,538 |
$770.96 |
| D0140 |
Limited oral evaluation - problem focused |
828 |
732 |
$585.00 |
| 91322 |
|
196 |
189 |
$443.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,985 |
2,614 |
$329.22 |
| 0012A |
|
508 |
503 |
$280.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,129 |
606 |
$276.96 |
| 0011A |
|
454 |
452 |
$200.80 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
102 |
90 |
$166.09 |
| 99215 |
Prolong outpt/office vis |
489 |
342 |
$156.52 |
| G0008 |
Administration of influenza virus vaccine |
1,590 |
900 |
$121.30 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
202 |
156 |
$114.77 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
20 |
16 |
$96.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
110 |
92 |
$72.91 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
300 |
276 |
$62.25 |
| 90656 |
|
1,529 |
1,025 |
$37.22 |
| 90686 |
|
596 |
497 |
$17.97 |
| 91301 |
|
240 |
236 |
$0.01 |
| D0999 |
Unspecified diagnostic procedure, by report |
3,137 |
2,846 |
$0.00 |
| 90732 |
|
260 |
192 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
26 |
26 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
298 |
278 |
$0.00 |
| 97802 |
|
209 |
134 |
$0.00 |
| 0031A |
|
136 |
136 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
21 |
13 |
$0.00 |
| 90480 |
|
220 |
213 |
$0.00 |
| 90651 |
|
14 |
12 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
18 |
12 |
$0.00 |
| D2999 |
|
2,839 |
2,175 |
$0.00 |
| 90662 |
|
2,323 |
1,606 |
$0.00 |
| 90734 |
|
312 |
304 |
$0.00 |
| 90670 |
|
56 |
42 |
$0.00 |
| D1999 |
|
299 |
247 |
$0.00 |
| 90750 |
|
262 |
208 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
88 |
78 |
$0.00 |
| 90715 |
|
177 |
160 |
$0.00 |
| 91312 |
|
67 |
66 |
$0.00 |
| D4341 |
|
237 |
121 |
$0.00 |
| J0741 |
Injection, cabotegravir and rilpivirine, 2mg/3mg |
102 |
88 |
$0.00 |
| D2751 |
Crown - porcelain fused to predominantly base metal |
148 |
103 |
$0.00 |
| 90746 |
|
93 |
76 |
$0.00 |
| 0124A |
|
69 |
67 |
$0.00 |