| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
36,429 |
30,127 |
$6.65M |
| D0999 |
Unspecified diagnostic procedure, by report |
1,500 |
1,342 |
$244K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
280 |
237 |
$51K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,712 |
5,379 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,985 |
10,341 |
$18K |
| 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 |
213 |
171 |
$13K |
| 90837 |
Psychotherapy, 53 minutes with patient |
374 |
204 |
$2K |
| 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 |
253 |
252 |
$1K |
| 0002A |
|
26 |
26 |
$687.77 |
| 0072A |
|
16 |
16 |
$599.85 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
711 |
703 |
$387.58 |
| 99215 |
Prolong outpt/office vis |
43 |
42 |
$347.78 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,228 |
1,200 |
$326.75 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,479 |
1,474 |
$290.88 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,383 |
667 |
$273.33 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
273 |
214 |
$222.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,463 |
3,424 |
$178.23 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
526 |
520 |
$109.42 |
| 90686 |
|
463 |
458 |
$96.58 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
25 |
25 |
$62.40 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,719 |
1,701 |
$46.29 |
| 90832 |
Psychotherapy, 30 minutes with patient |
553 |
348 |
$30.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
759 |
756 |
$27.60 |
| 85018 |
|
13 |
13 |
$19.22 |
| 99173 |
|
526 |
526 |
$3.58 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
169 |
169 |
$0.00 |
| 96127 |
|
39 |
39 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
125 |
125 |
$0.00 |
| 90697 |
|
26 |
26 |
$0.00 |
| 90698 |
|
56 |
56 |
$0.00 |
| 36416 |
|
37 |
37 |
$0.00 |
| D0602 |
|
28 |
28 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
421 |
421 |
$0.00 |
| 90744 |
|
40 |
39 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
39 |
39 |
$0.00 |
| D1330 |
|
202 |
202 |
$0.00 |
| 96161 |
|
99 |
98 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
161 |
160 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
256 |
98 |
$0.00 |
| D0603 |
|
128 |
128 |
$0.00 |
| D0601 |
|
14 |
14 |
$0.00 |
| 90474 |
|
13 |
13 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
54 |
54 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
265 |
265 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
62 |
59 |
$0.00 |
| 90670 |
|
233 |
231 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
318 |
318 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
51 |
51 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
165 |
163 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
16 |
$0.00 |
| 99177 |
|
27 |
27 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
169 |
65 |
$0.00 |
| 90671 |
|
15 |
15 |
$0.00 |
| 80061 |
Lipid panel |
14 |
14 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$0.00 |
| 90734 |
|
25 |
24 |
$0.00 |
| 81002 |
|
14 |
14 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |