| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,145 |
24,832 |
$5.26M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,870 |
9,235 |
$2K |
| 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 |
1,438 |
1,174 |
$424.89 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,027 |
3,566 |
$163.34 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
326 |
188 |
$128.87 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,393 |
813 |
$87.59 |
| D0140 |
Limited oral evaluation - problem focused |
2,068 |
1,772 |
$39.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
153 |
133 |
$18.97 |
| 90686 |
|
383 |
348 |
$15.37 |
| D1110 |
Prophylaxis - adult |
900 |
737 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
383 |
355 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
211 |
133 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
2,155 |
1,827 |
$0.00 |
| 3078F |
|
1,215 |
1,138 |
$0.00 |
| 4004F |
|
181 |
166 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
345 |
310 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
115 |
102 |
$0.00 |
| 81003 |
|
45 |
40 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
189 |
182 |
$0.00 |
| 3077F |
|
395 |
363 |
$0.00 |
| 1159F |
|
652 |
598 |
$0.00 |
| 99173 |
|
14 |
14 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
17 |
13 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
764 |
727 |
$0.00 |
| 3080F |
|
297 |
272 |
$0.00 |
| 3075F |
|
275 |
267 |
$0.00 |
| 3074F |
|
1,341 |
1,241 |
$0.00 |
| 3079F |
|
448 |
432 |
$0.00 |
| 3008F |
|
1,682 |
1,546 |
$0.00 |
| 1036F |
|
1,571 |
1,420 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
307 |
243 |
$0.00 |
| 92551 |
|
148 |
136 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
169 |
137 |
$0.00 |
| 3044F |
|
85 |
81 |
$0.00 |
| 2001F |
|
1,878 |
1,713 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
43 |
40 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
30 |
28 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
33 |
30 |
$0.00 |
| 90656 |
|
30 |
30 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
15 |
15 |
$0.00 |