| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
48,644 |
41,200 |
$13.58M |
| D9999 |
Unspecified adjunctive procedure, by report |
3,233 |
2,981 |
$932K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
68,202 |
67,951 |
$389K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
56,658 |
56,221 |
$328K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,920 |
16,100 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,978 |
14,203 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
63 |
61 |
$7K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,160 |
1,290 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
179 |
173 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
443 |
425 |
$349.11 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
77 |
61 |
$296.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
143 |
142 |
$196.04 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
525 |
491 |
$157.61 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,050 |
1,015 |
$148.87 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
187 |
172 |
$144.48 |
| 90834 |
Psychotherapy, 45 minutes with patient |
952 |
680 |
$99.94 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
234 |
232 |
$78.27 |
| 96127 |
|
1,541 |
1,419 |
$62.22 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,850 |
3,660 |
$55.30 |
| 36415 |
Collection of venous blood by venipuncture |
373 |
320 |
$9.51 |
| 84703 |
|
149 |
126 |
$9.44 |
| 85013 |
|
162 |
155 |
$4.68 |
| 36416 |
|
406 |
361 |
$2.86 |
| 85018 |
|
29 |
28 |
$1.95 |
| 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 |
1,288 |
1,023 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
142 |
141 |
$0.00 |
| 90686 |
|
745 |
708 |
$0.00 |
| 90680 |
|
225 |
212 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
276 |
265 |
$0.00 |
| 90656 |
|
108 |
105 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
261 |
254 |
$0.00 |
| 87081 |
|
13 |
13 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
103 |
72 |
$0.00 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
53 |
49 |
$0.00 |
| 99000 |
|
178 |
163 |
$0.00 |
| 90697 |
|
281 |
266 |
$0.00 |
| 90677 |
|
82 |
76 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
63 |
57 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
44 |
37 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
44 |
43 |
$0.00 |
| 90698 |
|
30 |
30 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
20 |
17 |
$0.00 |
| 90744 |
|
26 |
26 |
$0.00 |
| 99406 |
|
13 |
12 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
28 |
28 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
12 |
12 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| D1110 |
Prophylaxis - adult |
259 |
253 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,450 |
1,349 |
$0.00 |
| 90671 |
|
219 |
213 |
$0.00 |
| 90633 |
|
260 |
241 |
$0.00 |
| 90461 |
|
83 |
83 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
12 |
12 |
$0.00 |
| 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 |
386 |
216 |
$0.00 |
| 90670 |
|
268 |
262 |
$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 |
31 |
24 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
60 |
52 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
175 |
167 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
55 |
38 |
$0.00 |
| 99188 |
|
130 |
125 |
$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 |
14 |
14 |
$0.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$0.00 |
| 90648 |
|
16 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
13 |
12 |
$0.00 |
| 90681 |
|
18 |
18 |
$0.00 |