| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
109,711 |
82,328 |
$19.42M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45,925 |
34,704 |
$292K |
| D0120 |
Periodic oral evaluation - established patient |
7,807 |
7,403 |
$220K |
| 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 |
13,132 |
8,070 |
$191K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30,671 |
25,251 |
$179K |
| D1120 |
Prophylaxis - child |
5,023 |
4,770 |
$171K |
| D1110 |
Prophylaxis - adult |
2,492 |
2,388 |
$137K |
| D1208 |
Topical application of fluoride, excluding varnish |
7,037 |
6,673 |
$120K |
| D7140 |
Extraction, erupted tooth or exposed root |
771 |
410 |
$73K |
| D0140 |
Limited oral evaluation - problem focused |
1,368 |
1,257 |
$58K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
532 |
357 |
$53K |
| D0274 |
Bitewings - four radiographic images |
1,506 |
1,460 |
$50K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
3,634 |
1,695 |
$49K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
654 |
627 |
$36K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
606 |
553 |
$30K |
| D0272 |
Bitewings - two radiographic images |
926 |
910 |
$24K |
| 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 |
1,965 |
675 |
$19K |
| D1351 |
Sealant - per tooth |
622 |
128 |
$15K |
| 3078F |
|
7,091 |
6,094 |
$11K |
| 3074F |
|
8,368 |
7,135 |
$10K |
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
161 |
54 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
1,246 |
1,172 |
$9K |
| D2140 |
|
93 |
71 |
$8K |
| 90686 |
|
1,267 |
1,161 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
455 |
392 |
$6K |
| 3079F |
|
2,436 |
2,057 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
10,686 |
6,202 |
$5K |
| 81002 |
|
3,324 |
2,117 |
$4K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
53 |
41 |
$4K |
| 80305 |
|
582 |
421 |
$3K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
540 |
494 |
$2K |
| 90715 |
|
76 |
60 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
925 |
831 |
$2K |
| 90756 |
|
174 |
159 |
$2K |
| 90670 |
|
850 |
702 |
$1K |
| 90461 |
|
2,411 |
2,083 |
$994.02 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,339 |
3,778 |
$768.71 |
| 3075F |
|
716 |
602 |
$632.89 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
84 |
82 |
$602.08 |
| 0003A |
|
27 |
26 |
$509.42 |
| 0001A |
|
36 |
28 |
$484.00 |
| D4910 |
|
13 |
13 |
$479.19 |
| 90656 |
|
210 |
202 |
$364.16 |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,451 |
1,938 |
$335.15 |
| 85018 |
|
165 |
132 |
$300.89 |
| 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 |
50 |
50 |
$257.41 |
| 99215 |
Prolong outpt/office vis |
137 |
117 |
$192.74 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,279 |
1,122 |
$186.12 |
| 87400 |
|
35 |
29 |
$167.22 |
| 3725F |
|
2,457 |
2,147 |
$166.89 |
| 87276 |
|
12 |
12 |
$148.06 |
| 92551 |
|
157 |
150 |
$147.96 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$136.11 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,355 |
1,092 |
$135.90 |
| 83655 |
|
13 |
13 |
$135.20 |
| 87430 |
|
13 |
12 |
$119.60 |
| 99177 |
|
18 |
18 |
$99.61 |
| 81025 |
|
35 |
27 |
$80.24 |
| D0230 |
Intraoral - periapical each additional radiographic image |
17 |
12 |
$75.00 |
| 90648 |
|
770 |
635 |
$60.00 |
| 82947 |
|
12 |
12 |
$39.75 |
| 90837 |
Psychotherapy, 53 minutes with patient |
226 |
139 |
$37.00 |
| 82948 |
|
145 |
112 |
$18.03 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$15.25 |
| 94760 |
|
71 |
64 |
$11.80 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
52 |
51 |
$2.00 |
| 1159F |
|
6,030 |
5,028 |
$0.09 |
| 1160F |
|
6,027 |
5,026 |
$0.09 |
| 3008F |
|
12,374 |
10,438 |
$0.02 |
| 1036F |
|
2,779 |
2,251 |
$0.00 |
| D0603 |
|
1,881 |
1,821 |
$0.00 |
| D0602 |
|
1,036 |
1,020 |
$0.00 |
| 1034F |
|
867 |
725 |
$0.00 |
| D0601 |
|
273 |
270 |
$0.00 |
| 1126F |
|
996 |
866 |
$0.00 |
| 90680 |
|
370 |
325 |
$0.00 |
| T1016 |
Case management, each 15 minutes |
21 |
21 |
$0.00 |
| 1125F |
|
194 |
167 |
$0.00 |
| 90697 |
|
85 |
82 |
$0.00 |
| 90716 |
|
31 |
27 |
$0.00 |
| 1035F |
|
64 |
54 |
$0.00 |
| 90723 |
|
433 |
357 |
$0.00 |
| 90677 |
|
157 |
154 |
$0.00 |
| 3080F |
|
79 |
68 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
735 |
648 |
$0.00 |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
18 |
15 |
$0.00 |
| 3077F |
|
379 |
325 |
$0.00 |
| 90707 |
|
33 |
29 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
77 |
69 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
462 |
396 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
154 |
122 |
$0.00 |
| 90633 |
|
70 |
58 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
18 |
$0.00 |
| 99173 |
|
123 |
116 |
$0.00 |
| 91300 |
|
88 |
68 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
76 |
72 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
66 |
64 |
$0.00 |
| 90700 |
|
13 |
12 |
$0.00 |
| 90868 |
|
60 |
40 |
$0.00 |
| 90734 |
|
15 |
12 |
$0.00 |
| 90649 |
|
16 |
13 |
$0.00 |
| 90685 |
|
20 |
13 |
$0.00 |