| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
100,681 |
79,173 |
$13.01M |
| 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 |
3,604 |
3,555 |
$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 |
8,222 |
6,950 |
$33K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,108 |
958 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,917 |
26,324 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17,408 |
13,783 |
$360.11 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,635 |
11,718 |
$339.49 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,698 |
1,806 |
$126.76 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,220 |
1,184 |
$113.99 |
| 93000 |
|
78 |
74 |
$19.12 |
| D0220 |
Intraoral - periapical first radiographic image |
2,835 |
2,310 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
419 |
407 |
$0.00 |
| D0330 |
Panoramic radiographic image |
860 |
677 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,213 |
1,095 |
$0.00 |
| 98940 |
|
2,745 |
1,445 |
$0.00 |
| 99401 |
|
3,435 |
3,119 |
$0.00 |
| D1110 |
Prophylaxis - adult |
5,467 |
4,673 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
333 |
325 |
$0.00 |
| 92015 |
Determination of refractive state |
57 |
57 |
$0.00 |
| 98960 |
|
58 |
56 |
$0.00 |
| 99442 |
|
1,559 |
1,426 |
$0.00 |
| 81002 |
|
71 |
70 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
597 |
560 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
28 |
27 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
32 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 80306 |
|
42 |
41 |
$0.00 |
| 0124A |
|
35 |
27 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
187 |
146 |
$0.00 |
| 0071A |
|
20 |
19 |
$0.00 |
| 91300 |
|
30 |
30 |
$0.00 |
| 0054A |
|
30 |
27 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
28 |
25 |
$0.00 |
| D1120 |
Prophylaxis - child |
27 |
24 |
$0.00 |
| D0270 |
|
15 |
13 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
30 |
25 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
12 |
$0.00 |
| 0004A |
|
73 |
71 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
3,074 |
2,624 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,322 |
989 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
687 |
584 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
438 |
349 |
$0.00 |
| 99441 |
|
250 |
228 |
$0.00 |
| 99406 |
|
779 |
717 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
514 |
424 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
2,605 |
2,418 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
794 |
740 |
$0.00 |
| 99443 |
|
833 |
752 |
$0.00 |
| 92558 |
|
13 |
13 |
$0.00 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,951 |
992 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
375 |
233 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
26 |
13 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
545 |
361 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
58 |
42 |
$0.00 |
| D5899 |
|
126 |
64 |
$0.00 |
| 98943 |
|
22 |
14 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
17 |
14 |
$0.00 |
| 0072A |
|
12 |
12 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$0.00 |
| 96127 |
|
21 |
20 |
$0.00 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
136 |
73 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12 |
12 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 88142 |
|
13 |
13 |
$0.00 |
| 0064A |
|
18 |
18 |
$0.00 |
| 85018 |
|
47 |
45 |
$0.00 |
| D2331 |
|
20 |
13 |
$0.00 |