| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
108,955 |
84,905 |
$14.50M |
| D9430 |
|
1,290 |
877 |
$141K |
| 90651 |
|
2,235 |
2,080 |
$30K |
| 90686 |
|
3,531 |
3,447 |
$28K |
| 90670 |
|
1,977 |
1,919 |
$20K |
| 90734 |
|
1,298 |
1,242 |
$16K |
| 90633 |
|
1,712 |
1,600 |
$13K |
| 90723 |
|
934 |
908 |
$8K |
| 90648 |
|
758 |
724 |
$6K |
| 90681 |
|
538 |
523 |
$5K |
| 90710 |
|
549 |
518 |
$4K |
| 90700 |
|
516 |
498 |
$4K |
| 90715 |
|
512 |
479 |
$4K |
| 90647 |
|
409 |
406 |
$3K |
| 90620 |
|
268 |
254 |
$3K |
| 90656 |
|
534 |
289 |
$2K |
| 90621 |
|
204 |
160 |
$2K |
| 90688 |
|
430 |
404 |
$2K |
| 90677 |
|
117 |
106 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44,610 |
35,849 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
34,671 |
25,910 |
$1K |
| 90696 |
|
130 |
118 |
$904.00 |
| 90619 |
|
191 |
145 |
$876.00 |
| 90685 |
|
66 |
65 |
$553.43 |
| 90716 |
|
26 |
26 |
$472.34 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,399 |
2,887 |
$415.60 |
| 92551 |
|
8,307 |
7,207 |
$324.33 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,424 |
3,167 |
$302.64 |
| D1208 |
Topical application of fluoride, excluding varnish |
412 |
342 |
$180.00 |
| 90697 |
|
107 |
72 |
$120.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
568 |
491 |
$119.64 |
| 90658 |
|
13 |
13 |
$104.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,969 |
2,641 |
$71.18 |
| 99173 |
|
9,440 |
7,959 |
$60.19 |
| D1120 |
Prophylaxis - child |
245 |
195 |
$36.00 |
| D0120 |
Periodic oral evaluation - established patient |
150 |
130 |
$25.00 |
| 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 |
4,808 |
4,613 |
$0.00 |
| 36416 |
|
2,008 |
1,338 |
$0.00 |
| 82962 |
|
2,185 |
1,790 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,064 |
1,423 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,550 |
1,351 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
58 |
37 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
274 |
220 |
$0.00 |
| 1036F |
|
191 |
137 |
$0.00 |
| 3008F |
|
422 |
314 |
$0.00 |
| D1330 |
|
14 |
14 |
$0.00 |
| 96127 |
|
266 |
211 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
71 |
58 |
$0.00 |
| 3074F |
|
122 |
88 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
240 |
174 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
166 |
109 |
$0.00 |
| 81000 |
|
46 |
42 |
$0.00 |
| 99384 |
|
66 |
57 |
$0.00 |
| 99383 |
|
61 |
57 |
$0.00 |
| 3079F |
|
45 |
40 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
37 |
32 |
$0.00 |
| 0012A |
|
106 |
74 |
$0.00 |
| 99406 |
|
14 |
13 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
216 |
170 |
$0.00 |
| 0011A |
|
156 |
100 |
$0.00 |
| 3080F |
|
14 |
12 |
$0.00 |
| 87428 |
|
43 |
31 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
120 |
76 |
$0.00 |
| 1126F |
|
117 |
86 |
$0.00 |
| 1125F |
|
113 |
90 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
19 |
12 |
$0.00 |
| 3075F |
|
19 |
15 |
$0.00 |
| 0001A |
|
18 |
15 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
301 |
212 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,860 |
1,602 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,751 |
2,289 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
491 |
366 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
1,051 |
788 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
623 |
550 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
435 |
386 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
149 |
105 |
$0.00 |
| 96160 |
|
311 |
219 |
$0.00 |
| 81003 |
|
353 |
301 |
$0.00 |
| 81025 |
|
851 |
603 |
$0.00 |
| 1160F |
|
407 |
308 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
111 |
71 |
$0.00 |
| 3725F |
|
228 |
178 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
370 |
352 |
$0.00 |
| 3078F |
|
136 |
95 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
28 |
27 |
$0.00 |
| 99001 |
|
175 |
168 |
$0.00 |
| D0330 |
Panoramic radiographic image |
112 |
83 |
$0.00 |
| 1159F |
|
16 |
16 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
158 |
83 |
$0.00 |
| 87400 |
|
14 |
14 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
28 |
15 |
$0.00 |
| D1110 |
Prophylaxis - adult |
15 |
14 |
$0.00 |
| 3077F |
|
61 |
46 |
$0.00 |
| 0002A |
|
12 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
12 |
$0.00 |
| 0071A |
|
34 |
31 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
45 |
37 |
$0.00 |
| 99408 |
|
20 |
18 |
$0.00 |