| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
346,756 |
258,422 |
$66.67M |
| D9430 |
|
9,946 |
7,444 |
$1.97M |
| Q3014 |
Telehealth originating site facility fee |
1,397 |
1,247 |
$24K |
| 90686 |
|
2,069 |
1,980 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
112,737 |
86,908 |
$21K |
| 90688 |
|
984 |
917 |
$12K |
| 90674 |
|
186 |
184 |
$4K |
| 90656 |
|
342 |
290 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,952 |
1,753 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
953 |
572 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
131 |
112 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109,026 |
86,070 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
710 |
613 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,683 |
1,507 |
$1K |
| 90670 |
|
160 |
159 |
$1K |
| 96127 |
|
585 |
548 |
$1K |
| 90698 |
|
120 |
120 |
$952.00 |
| 90677 |
|
129 |
106 |
$840.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,834 |
1,640 |
$741.68 |
| 90680 |
|
72 |
72 |
$576.00 |
| D0120 |
Periodic oral evaluation - established patient |
3,531 |
3,017 |
$455.00 |
| 90744 |
|
38 |
28 |
$216.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
12 |
$182.09 |
| 90651 |
|
21 |
21 |
$168.00 |
| 90756 |
|
173 |
166 |
$159.53 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
193 |
187 |
$155.10 |
| 90660 |
|
12 |
12 |
$96.00 |
| 0012A |
|
299 |
297 |
$19.70 |
| 0011A |
|
447 |
432 |
$8.07 |
| D1208 |
Topical application of fluoride, excluding varnish |
4,907 |
4,017 |
$0.00 |
| 0001A |
|
511 |
487 |
$0.00 |
| 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 |
3,654 |
3,328 |
$0.00 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
649 |
257 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
458 |
371 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
796 |
659 |
$0.00 |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
370 |
313 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
400 |
370 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
2,031 |
918 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
78 |
46 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
242 |
140 |
$0.00 |
| 3008F |
|
46 |
43 |
$0.00 |
| D1351 |
Sealant - per tooth |
186 |
46 |
$0.00 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
17 |
12 |
$0.00 |
| 0031A |
|
64 |
63 |
$0.00 |
| 3074F |
|
54 |
48 |
$0.00 |
| 0072A |
|
104 |
103 |
$0.00 |
| 76801 |
|
37 |
17 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
28 |
12 |
$0.00 |
| 99305 |
|
23 |
14 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
73 |
72 |
$0.00 |
| D1120 |
Prophylaxis - child |
3,003 |
2,566 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
2,621 |
2,127 |
$0.00 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,307 |
1,678 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
266 |
226 |
$0.00 |
| 81002 |
|
993 |
447 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
474 |
390 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,061 |
810 |
$0.00 |
| D0330 |
Panoramic radiographic image |
279 |
235 |
$0.00 |
| D1110 |
Prophylaxis - adult |
563 |
482 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
401 |
376 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
548 |
473 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
205 |
174 |
$0.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
262 |
238 |
$0.00 |
| 0002A |
|
331 |
328 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
139 |
116 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
309 |
170 |
$0.00 |
| 1159F |
|
64 |
58 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,498 |
1,047 |
$0.00 |
| 0071A |
|
148 |
147 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
175 |
72 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
16 |
12 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
108 |
101 |
$0.00 |
| 1160F |
|
47 |
44 |
$0.00 |
| 0053A |
|
28 |
14 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
42 |
32 |
$0.00 |
| 99201 |
|
19 |
19 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
39 |
28 |
$0.00 |
| 99223 |
Prolong inpt eval add15 m |
27 |
25 |
$0.00 |
| 3725F |
|
15 |
14 |
$0.00 |
| 3078F |
|
39 |
36 |
$0.00 |