| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
144,570 |
103,721 |
$15.66M |
| D9430 |
|
13,554 |
8,296 |
$1.14M |
| 90686 |
|
957 |
828 |
$10K |
| 90715 |
|
264 |
248 |
$4K |
| 90651 |
|
541 |
509 |
$4K |
| 90700 |
|
609 |
567 |
$3K |
| 90713 |
|
393 |
370 |
$2K |
| 90734 |
|
202 |
190 |
$1K |
| 90670 |
|
151 |
144 |
$872.00 |
| 90633 |
|
114 |
111 |
$736.00 |
| 90648 |
|
137 |
132 |
$656.00 |
| 90716 |
|
55 |
54 |
$416.00 |
| 90674 |
|
61 |
26 |
$407.87 |
| 90619 |
|
41 |
40 |
$312.00 |
| 90744 |
|
45 |
43 |
$224.00 |
| 90707 |
|
25 |
24 |
$184.00 |
| 90680 |
|
32 |
30 |
$128.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32,155 |
24,210 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,195 |
27,034 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
4,575 |
3,398 |
$0.00 |
| 92002 |
|
3,858 |
3,471 |
$0.00 |
| D0603 |
|
175 |
170 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
7,481 |
4,411 |
$0.00 |
| 92551 |
|
67 |
60 |
$0.00 |
| D0601 |
|
337 |
326 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
3,013 |
2,295 |
$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 |
544 |
526 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
709 |
461 |
$0.00 |
| 87428 |
|
297 |
241 |
$0.00 |
| 0031A |
|
13 |
13 |
$0.00 |
| 99384 |
|
53 |
28 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
22 |
12 |
$0.00 |
| D0602 |
|
35 |
35 |
$0.00 |
| 0011A |
|
127 |
126 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
17 |
12 |
$0.00 |
| 0012A |
|
88 |
87 |
$0.00 |
| 99406 |
|
129 |
36 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
25 |
14 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
137 |
111 |
$0.00 |
| 99462 |
|
40 |
25 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
13 |
$0.00 |
| D1330 |
|
17 |
13 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
13 |
13 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
26 |
15 |
$0.00 |
| 0001A |
|
18 |
18 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
921 |
682 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14,023 |
11,476 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,650 |
3,302 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
675 |
530 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
397 |
262 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
946 |
758 |
$0.00 |
| 11721 |
|
119 |
80 |
$0.00 |
| 81025 |
|
698 |
465 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,013 |
923 |
$0.00 |
| D1120 |
Prophylaxis - child |
153 |
94 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
203 |
130 |
$0.00 |
| 82947 |
|
173 |
129 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
615 |
415 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
159 |
114 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
331 |
214 |
$0.00 |
| 90863 |
|
42 |
25 |
$0.00 |
| 92015 |
Determination of refractive state |
1,279 |
1,175 |
$0.00 |
| 81003 |
|
114 |
80 |
$0.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
71 |
70 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
69 |
37 |
$0.00 |
| D1110 |
Prophylaxis - adult |
324 |
261 |
$0.00 |
| 99442 |
|
50 |
45 |
$0.00 |
| D0330 |
Panoramic radiographic image |
39 |
25 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
103 |
43 |
$0.00 |
| 4004F |
|
17 |
16 |
$0.00 |
| 99173 |
|
51 |
48 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
86 |
57 |
$0.00 |
| 99382 |
|
32 |
32 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
29 |
12 |
$0.00 |