| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
67,648 |
41,316 |
$12.65M |
| T1016 |
Case management, each 15 minutes |
6,545 |
5,131 |
$119K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,693 |
9,085 |
$564.84 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,182 |
1,059 |
$385.80 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,881 |
11,135 |
$111.36 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
487 |
421 |
$85.30 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
954 |
856 |
$77.17 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,610 |
1,405 |
$74.24 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
24,296 |
11,521 |
$72.00 |
| 1159F |
|
3,057 |
2,671 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
420 |
385 |
$0.00 |
| 3077F |
|
317 |
283 |
$0.00 |
| 3078F |
|
2,626 |
2,343 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
2,621 |
2,116 |
$0.00 |
| 91320 |
|
36 |
15 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
83 |
66 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
209 |
186 |
$0.00 |
| 97803 |
|
402 |
319 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
256 |
207 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
476 |
266 |
$0.00 |
| 1160F |
|
3,058 |
2,672 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
330 |
191 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
360 |
245 |
$0.00 |
| 80305 |
|
96 |
86 |
$0.00 |
| 4274F |
|
678 |
578 |
$0.00 |
| 4040F |
|
134 |
113 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
321 |
255 |
$0.00 |
| 81025 |
|
152 |
140 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
257 |
208 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
198 |
166 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
99 |
84 |
$0.00 |
| 81002 |
|
95 |
75 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
129 |
108 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$0.00 |
| D0190 |
|
94 |
92 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
182 |
171 |
$0.00 |
| D0270 |
|
55 |
55 |
$0.00 |
| D1321 |
|
24 |
24 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
18 |
18 |
$0.00 |
| 96160 |
|
14 |
13 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
19 |
14 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
23 |
13 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$0.00 |
| 3080F |
|
180 |
167 |
$0.00 |
| 3075F |
|
517 |
495 |
$0.00 |
| 2010F |
|
4,051 |
3,496 |
$0.00 |
| 2001F |
|
3,963 |
3,425 |
$0.00 |
| 90656 |
|
92 |
39 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
470 |
288 |
$0.00 |
| 2000F |
|
3,776 |
3,265 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
101 |
99 |
$0.00 |
| 3074F |
|
2,878 |
2,573 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
272 |
239 |
$0.00 |
| 96150 |
|
182 |
117 |
$0.00 |
| 3079F |
|
891 |
832 |
$0.00 |
| 3008F |
|
3,923 |
3,388 |
$0.00 |
| 4010F |
|
223 |
174 |
$0.00 |
| 97802 |
|
1,171 |
942 |
$0.00 |
| 1126F |
|
336 |
320 |
$0.00 |
| 3351F |
|
1,125 |
1,073 |
$0.00 |
| 4037F |
|
35 |
33 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
80 |
58 |
$0.00 |
| 1036F |
|
3,389 |
2,918 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
230 |
203 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,800 |
1,443 |
$0.00 |
| 1034F |
|
415 |
340 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
127 |
124 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
144 |
114 |
$0.00 |
| 87428 |
|
140 |
118 |
$0.00 |
| 90686 |
|
249 |
207 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
813 |
692 |
$0.00 |
| 96127 |
|
31 |
31 |
$0.00 |
| 93000 |
|
15 |
15 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
25 |
$0.00 |
| 96156 |
|
637 |
540 |
$0.00 |
| 99383 |
|
18 |
17 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
40 |
40 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
25 |
$0.00 |
| 99384 |
|
13 |
13 |
$0.00 |
| 1125F |
|
29 |
29 |
$0.00 |
| 99385 |
|
26 |
26 |
$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 |
29 |
24 |
$0.00 |
| D1320 |
|
27 |
27 |
$0.00 |
| 3352F |
|
15 |
15 |
$0.00 |
| 90480 |
|
33 |
15 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$0.00 |