| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
60,107 |
46,278 |
$10.50M |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
4,191 |
3,986 |
$154K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,445 |
23,222 |
$143K |
| D9999 |
Unspecified adjunctive procedure, by report |
489 |
436 |
$72K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,059 |
6,043 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,414 |
6,857 |
$31K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,328 |
2,056 |
$14K |
| 90686 |
|
874 |
765 |
$11K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,797 |
2,717 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
800 |
599 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
273 |
245 |
$3K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
159 |
65 |
$3K |
| D1110 |
Prophylaxis - adult |
103 |
100 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
903 |
798 |
$2K |
| 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 |
3,755 |
3,017 |
$2K |
| D1120 |
Prophylaxis - child |
91 |
89 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
260 |
229 |
$2K |
| D0274 |
Bitewings - four radiographic images |
94 |
92 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
125 |
123 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
219 |
86 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
114 |
113 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
50 |
49 |
$1K |
| D0330 |
Panoramic radiographic image |
57 |
57 |
$884.40 |
| D0220 |
Intraoral - periapical first radiographic image |
211 |
186 |
$836.08 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
238 |
198 |
$749.78 |
| 90656 |
|
71 |
69 |
$532.95 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
192 |
174 |
$436.22 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$247.50 |
| 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 |
3,172 |
2,670 |
$183.14 |
| 90791 |
Psychiatric diagnostic evaluation |
75 |
72 |
$125.05 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,015 |
896 |
$100.01 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
16 |
16 |
$5.36 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
146 |
124 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
16 |
13 |
$0.00 |
| 3078F |
|
643 |
535 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
119 |
106 |
$0.00 |
| 90648 |
|
39 |
36 |
$0.00 |
| 90670 |
|
74 |
64 |
$0.00 |
| 90734 |
|
89 |
76 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
110 |
97 |
$0.00 |
| 90715 |
|
100 |
89 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
48 |
44 |
$0.00 |
| 99201 |
|
32 |
26 |
$0.00 |
| 90633 |
|
14 |
13 |
$0.00 |
| 90710 |
|
13 |
12 |
$0.00 |
| 3074F |
|
862 |
756 |
$0.00 |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
793 |
661 |
$0.00 |
| 3008F |
|
582 |
554 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
47 |
47 |
$0.00 |
| 3079F |
|
89 |
72 |
$0.00 |
| 99384 |
|
29 |
26 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
48 |
26 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
23 |
17 |
$0.00 |
| 90651 |
|
30 |
24 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
55 |
50 |
$0.00 |
| 90698 |
|
13 |
12 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
13 |
13 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
25 |
25 |
$0.00 |