| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
36,160 |
26,510 |
$8.18M |
| T1016 |
Case management, each 15 minutes |
199 |
112 |
$13K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
581 |
391 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
204 |
200 |
$325.42 |
| 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 |
691 |
664 |
$234.83 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,471 |
1,392 |
$83.37 |
| 0011A |
|
175 |
173 |
$80.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
914 |
907 |
$76.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
512 |
499 |
$27.88 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,059 |
2,683 |
$17.88 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,384 |
1,216 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
489 |
474 |
$0.00 |
| 3080F |
|
141 |
133 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
788 |
438 |
$0.00 |
| 90686 |
|
50 |
50 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
2,814 |
2,548 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
342 |
312 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
548 |
443 |
$0.00 |
| 81000 |
|
699 |
591 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
153 |
140 |
$0.00 |
| 99441 |
|
1,329 |
1,251 |
$0.00 |
| 3079F |
|
626 |
566 |
$0.00 |
| 3074F |
|
1,916 |
1,677 |
$0.00 |
| 90656 |
|
214 |
214 |
$0.00 |
| 99381 |
|
32 |
31 |
$0.00 |
| 90680 |
|
43 |
43 |
$0.00 |
| 99443 |
|
312 |
294 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,081 |
849 |
$0.00 |
| 3075F |
|
206 |
196 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
27 |
$0.00 |
| 90723 |
|
28 |
28 |
$0.00 |
| D0240 |
|
216 |
143 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
27 |
25 |
$0.00 |
| 3008F |
|
3,608 |
2,980 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
252 |
251 |
$0.00 |
| D1351 |
Sealant - per tooth |
88 |
25 |
$0.00 |
| 1220F |
|
60 |
59 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
245 |
199 |
$0.00 |
| 91301 |
|
195 |
194 |
$0.00 |
| 1125F |
|
57 |
54 |
$0.00 |
| 0012A |
|
19 |
19 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,137 |
3,275 |
$0.00 |
| 90648 |
|
32 |
32 |
$0.00 |
| 99442 |
|
266 |
253 |
$0.00 |
| D1120 |
Prophylaxis - child |
2,578 |
2,310 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
139 |
103 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
229 |
220 |
$0.00 |
| 99201 |
|
324 |
322 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
23 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
68 |
$0.00 |
| 0502F |
|
240 |
151 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
150 |
136 |
$0.00 |
| D0191 |
|
1,744 |
1,609 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
840 |
473 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
46 |
40 |
$0.00 |
| 81025 |
|
46 |
46 |
$0.00 |
| 1160F |
|
627 |
564 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
284 |
209 |
$0.00 |
| 3078F |
|
1,509 |
1,353 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
13 |
13 |
$0.00 |
| 99173 |
|
114 |
114 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
108 |
70 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
25 |
24 |
$0.00 |
| 90670 |
|
37 |
37 |
$0.00 |
| H2014 |
Skills training and development, per 15 minutes |
59 |
38 |
$0.00 |
| 1159F |
|
14 |
13 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
135 |
49 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$0.00 |