| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
165,889 |
76,093 |
$35.94M |
| T1016 |
Case management, each 15 minutes |
5,454 |
1,479 |
$246K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,141 |
6,944 |
$115K |
| 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 |
2,879 |
2,675 |
$92K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,094 |
13,427 |
$67K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
5,049 |
982 |
$48K |
| D0140 |
Limited oral evaluation - problem focused |
1,130 |
1,121 |
$34K |
| 98968 |
|
863 |
354 |
$26K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,079 |
430 |
$21K |
| D0220 |
Intraoral - periapical first radiographic image |
1,215 |
1,208 |
$19K |
| D7140 |
Extraction, erupted tooth or exposed root |
204 |
123 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
458 |
458 |
$11K |
| 90846 |
Family psychotherapy without the patient present, 50 minutes |
382 |
181 |
$10K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
278 |
137 |
$7K |
| 0012A |
|
216 |
216 |
$4K |
| 0011A |
|
180 |
179 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,231 |
1,230 |
$3K |
| 0013A |
|
135 |
135 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,410 |
1,407 |
$2K |
| 0001A |
|
94 |
94 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
171 |
143 |
$1K |
| 0002A |
|
56 |
56 |
$1K |
| 0134A |
|
41 |
41 |
$802.78 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
58 |
58 |
$772.09 |
| 0071A |
|
36 |
35 |
$704.88 |
| 90656 |
|
42 |
42 |
$586.04 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,214 |
1,150 |
$550.03 |
| 98967 |
|
20 |
20 |
$434.20 |
| 92015 |
Determination of refractive state |
350 |
350 |
$370.00 |
| 36416 |
|
147 |
146 |
$352.44 |
| 0072A |
|
15 |
15 |
$293.70 |
| 99406 |
|
20 |
19 |
$263.60 |
| 0064A |
|
13 |
13 |
$254.54 |
| 92250 |
|
468 |
468 |
$179.46 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
58 |
58 |
$130.10 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$22.89 |
| 92002 |
|
124 |
124 |
$13.92 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$10.18 |
| 92083 |
|
12 |
12 |
$5.37 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
68 |
68 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
257 |
257 |
$0.00 |
| D0330 |
Panoramic radiographic image |
89 |
89 |
$0.00 |
| D1110 |
Prophylaxis - adult |
102 |
102 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
161 |
161 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
57 |
$0.00 |
| 81025 |
|
29 |
29 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
248 |
248 |
$0.00 |
| 90686 |
|
210 |
210 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
314 |
314 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
112 |
112 |
$0.00 |
| 91301 |
|
168 |
165 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
145 |
73 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
82 |
82 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
54 |
54 |
$0.00 |
| 99385 |
|
12 |
12 |
$0.00 |