| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
20,212 |
16,116 |
$4.19M |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,609 |
3,885 |
$223K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,223 |
4,821 |
$145K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,721 |
2,348 |
$72K |
| 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 |
1,787 |
1,578 |
$48K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,667 |
834 |
$36K |
| H0022 |
Alcohol and/or drug intervention service (planned facilitation) |
2,711 |
1,228 |
$22K |
| 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 |
548 |
250 |
$15K |
| 80047 |
|
1,384 |
1,173 |
$11K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
668 |
236 |
$11K |
| D1110 |
Prophylaxis - adult |
4,333 |
4,109 |
$11K |
| D0140 |
Limited oral evaluation - problem focused |
3,658 |
3,267 |
$9K |
| D1206 |
Topical application of fluoride varnish |
4,334 |
4,020 |
$7K |
| D0274 |
Bitewings - four radiographic images |
3,734 |
3,496 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
4,247 |
4,029 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,597 |
1,246 |
$5K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
429 |
164 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
654 |
561 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,113 |
813 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,121 |
792 |
$4K |
| D1120 |
Prophylaxis - child |
1,485 |
1,416 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,514 |
1,413 |
$3K |
| D0330 |
Panoramic radiographic image |
2,316 |
2,160 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
72 |
51 |
$2K |
| 90686 |
|
176 |
153 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
2,483 |
2,249 |
$2K |
| 90658 |
|
158 |
141 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
284 |
250 |
$2K |
| 0012A |
|
67 |
63 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
56 |
52 |
$1K |
| D1351 |
Sealant - per tooth |
620 |
190 |
$924.80 |
| 0011A |
|
77 |
68 |
$832.00 |
| D0272 |
Bitewings - two radiographic images |
537 |
508 |
$666.43 |
| 0002A |
|
22 |
22 |
$616.00 |
| D2330 |
|
74 |
39 |
$604.44 |
| D0230 |
Intraoral - periapical each additional radiographic image |
305 |
191 |
$397.20 |
| 0001A |
|
27 |
27 |
$384.00 |
| 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 |
15 |
14 |
$64.74 |
| 36415 |
Collection of venous blood by venipuncture |
1,943 |
1,650 |
$26.23 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
395 |
341 |
$2.92 |
| Q2037 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) |
56 |
52 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
15 |
$0.00 |
| D2394 |
|
12 |
12 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
177 |
157 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
96 |
96 |
$0.00 |
| D5899 |
|
337 |
185 |
$0.00 |
| D2335 |
|
16 |
15 |
$0.00 |