| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
24,743 |
20,160 |
$4.71M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,391 |
2,156 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
276 |
275 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,974 |
1,845 |
$1K |
| 99173 |
|
1,711 |
1,658 |
$430.80 |
| 92551 |
|
1,573 |
1,528 |
$232.00 |
| 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 |
15 |
13 |
$173.71 |
| 99442 |
|
473 |
439 |
$140.25 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
801 |
774 |
$102.85 |
| 3074F |
|
2,730 |
2,642 |
$97.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
218 |
210 |
$92.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
110 |
109 |
$80.00 |
| 3079F |
|
413 |
404 |
$64.65 |
| 3078F |
|
1,177 |
1,122 |
$62.61 |
| 90686 |
|
215 |
208 |
$60.00 |
| 0071A |
|
17 |
13 |
$40.00 |
| 36415 |
Collection of venous blood by venipuncture |
509 |
491 |
$31.40 |
| 3075F |
|
263 |
254 |
$14.69 |
| 96127 |
|
738 |
715 |
$10.00 |
| 3080F |
|
114 |
112 |
$10.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
31 |
31 |
$9.00 |
| 91307 |
|
19 |
15 |
$0.01 |
| 3077F |
|
344 |
332 |
$0.01 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
932 |
907 |
$0.00 |
| 3008F |
|
3,544 |
3,380 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
430 |
427 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
132 |
132 |
$0.00 |
| D1330 |
|
120 |
119 |
$0.00 |
| 99441 |
|
44 |
37 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
185 |
179 |
$0.00 |
| D1310 |
|
119 |
117 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
376 |
372 |
$0.00 |
| 90744 |
|
17 |
16 |
$0.00 |
| 90657 |
|
29 |
27 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
48 |
48 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
32 |
24 |
$0.00 |
| 85018 |
|
13 |
13 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
33 |
32 |
$0.00 |
| 90656 |
|
44 |
44 |
$0.00 |
| 3044F |
|
16 |
15 |
$0.00 |
| 90651 |
|
13 |
12 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
700 |
679 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
167 |
162 |
$0.00 |
| G9920 |
Screening performed and negative |
705 |
682 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
137 |
133 |
$0.00 |
| D1120 |
Prophylaxis - child |
274 |
271 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
167 |
166 |
$0.00 |
| 1160F |
|
95 |
89 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
132 |
131 |
$0.00 |
| 90461 |
|
40 |
40 |
$0.00 |
| 90658 |
|
14 |
14 |
$0.00 |
| 1159F |
|
113 |
102 |
$0.00 |
| 81025 |
|
13 |
12 |
$0.00 |
| 96160 |
|
33 |
33 |
$0.00 |
| D1110 |
Prophylaxis - adult |
77 |
77 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
28 |
26 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$0.00 |