| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
28,101 |
23,825 |
$3.87M |
| 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 |
1,313 |
1,147 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,318 |
8,808 |
$13K |
| 90791 |
Psychiatric diagnostic evaluation |
129 |
119 |
$9K |
| 96127 |
|
2,851 |
2,690 |
$8K |
| 90832 |
Psychotherapy, 30 minutes with patient |
313 |
256 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,114 |
2,720 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
886 |
826 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
297 |
255 |
$2K |
| 90688 |
|
222 |
197 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
164 |
164 |
$1K |
| 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 |
153 |
150 |
$680.85 |
| D1120 |
Prophylaxis - child |
26 |
26 |
$570.00 |
| D1206 |
Topical application of fluoride varnish |
29 |
29 |
$420.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
160 |
121 |
$387.84 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
102 |
86 |
$380.32 |
| 90658 |
|
20 |
20 |
$361.20 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
137 |
118 |
$277.18 |
| 92551 |
|
332 |
304 |
$246.66 |
| 99215 |
Prolong outpt/office vis |
14 |
14 |
$114.40 |
| D1110 |
Prophylaxis - adult |
14 |
14 |
$110.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
532 |
484 |
$107.04 |
| D0220 |
Intraoral - periapical first radiographic image |
24 |
24 |
$100.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,167 |
1,990 |
$93.04 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
44 |
30 |
$54.83 |
| 90686 |
|
85 |
74 |
$54.04 |
| D0230 |
Intraoral - periapical each additional radiographic image |
18 |
18 |
$51.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
61 |
48 |
$50.32 |
| D0210 |
Intraoral - complete series of radiographic images |
62 |
62 |
$27.00 |
| D0274 |
Bitewings - four radiographic images |
16 |
16 |
$18.00 |
| 96160 |
|
402 |
328 |
$14.00 |
| 83026 |
|
181 |
145 |
$12.90 |
| 85018 |
|
150 |
148 |
$8.28 |
| 81000 |
|
13 |
12 |
$5.16 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
48 |
44 |
$0.00 |
| 3078F |
|
598 |
576 |
$0.00 |
| 1159F |
|
468 |
422 |
$0.00 |
| 99173 |
|
252 |
221 |
$0.00 |
| 1160F |
|
468 |
422 |
$0.00 |
| 90662 |
|
17 |
16 |
$0.00 |
| 3077F |
|
16 |
16 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
65 |
60 |
$0.00 |
| 3074F |
|
692 |
669 |
$0.00 |
| 3008F |
|
1,117 |
1,063 |
$0.00 |
| 96150 |
|
14 |
12 |
$0.00 |
| D1310 |
|
15 |
15 |
$0.00 |
| D0603 |
|
47 |
47 |
$0.00 |
| D1330 |
|
70 |
70 |
$0.00 |
| 3079F |
|
39 |
37 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
13 |
$0.00 |