| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
64,681 |
44,172 |
$11.69M |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
7,773 |
6,823 |
$294K |
| 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 |
3,349 |
2,776 |
$192K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,824 |
15,049 |
$149K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,856 |
1,350 |
$136K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,983 |
14,925 |
$104K |
| 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 |
1,036 |
521 |
$58K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,029 |
3,084 |
$50K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,331 |
2,669 |
$35K |
| 90837 |
Psychotherapy, 53 minutes with patient |
4,312 |
2,402 |
$32K |
| 99215 |
Prolong outpt/office vis |
2,382 |
2,035 |
$20K |
| G0008 |
Administration of influenza virus vaccine |
3,404 |
3,148 |
$16K |
| 90480 |
|
333 |
330 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
481 |
408 |
$11K |
| 91322 |
|
132 |
127 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,685 |
1,626 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,578 |
1,530 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,107 |
1,037 |
$7K |
| D1206 |
Topical application of fluoride varnish |
5,377 |
4,990 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,922 |
1,717 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
993 |
900 |
$3K |
| 0134A |
|
103 |
102 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
414 |
399 |
$3K |
| 99000 |
|
848 |
788 |
$3K |
| 0124A |
|
88 |
86 |
$3K |
| 0064A |
|
106 |
93 |
$3K |
| 0031A |
|
173 |
173 |
$2K |
| 0011A |
|
98 |
97 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
922 |
802 |
$2K |
| 0012A |
|
98 |
96 |
$2K |
| 0071A |
|
71 |
61 |
$2K |
| 0072A |
|
63 |
56 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
917 |
860 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,955 |
3,797 |
$2K |
| 0111A |
|
45 |
43 |
$2K |
| D1110 |
Prophylaxis - adult |
1,459 |
1,371 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
144 |
121 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
605 |
564 |
$1K |
| 0001A |
|
26 |
26 |
$932.25 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,946 |
1,877 |
$798.64 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,688 |
4,361 |
$788.45 |
| 90461 |
|
2,952 |
2,733 |
$757.09 |
| D1120 |
Prophylaxis - child |
3,574 |
3,310 |
$690.00 |
| D0330 |
Panoramic radiographic image |
606 |
554 |
$656.52 |
| 90791 |
Psychiatric diagnostic evaluation |
267 |
249 |
$570.74 |
| D1351 |
Sealant - per tooth |
3,195 |
769 |
$568.52 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
481 |
355 |
$561.57 |
| 90715 |
|
823 |
798 |
$548.41 |
| 0164A |
|
13 |
13 |
$508.43 |
| 0002A |
|
12 |
12 |
$447.48 |
| G0010 |
Administration of hepatitis b vaccine |
13 |
13 |
$406.21 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
754 |
596 |
$375.31 |
| D0274 |
Bitewings - four radiographic images |
684 |
607 |
$375.31 |
| D0272 |
Bitewings - two radiographic images |
593 |
520 |
$222.32 |
| 91306 |
|
100 |
88 |
$199.44 |
| 90686 |
|
665 |
662 |
$192.64 |
| 90707 |
|
590 |
561 |
$186.26 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
14 |
$186.26 |
| 90744 |
|
899 |
875 |
$100.22 |
| 90651 |
|
598 |
588 |
$98.46 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
43 |
42 |
$77.66 |
| 99188 |
|
327 |
322 |
$68.52 |
| 90713 |
|
1,168 |
1,105 |
$63.82 |
| 99423 |
|
20 |
19 |
$33.27 |
| 90633 |
|
1,563 |
1,504 |
$33.15 |
| 90698 |
|
471 |
462 |
$0.00 |
| D1352 |
|
25 |
17 |
$0.00 |
| 90680 |
|
90 |
90 |
$0.00 |
| 90656 |
|
244 |
244 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
77 |
76 |
$0.00 |
| 91307 |
|
164 |
144 |
$0.00 |
| 90677 |
|
123 |
121 |
$0.00 |
| 91301 |
|
132 |
128 |
$0.00 |
| 91314 |
|
26 |
26 |
$0.00 |
| 90619 |
|
17 |
17 |
$0.00 |
| 91316 |
|
13 |
13 |
$0.00 |
| 90716 |
|
199 |
193 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
24 |
$0.00 |
| 99422 |
|
31 |
30 |
$0.00 |
| 91309 |
|
41 |
41 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
19 |
15 |
$0.00 |
| D7111 |
|
16 |
13 |
$0.00 |
| 91303 |
|
57 |
57 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
44 |
40 |
$0.00 |
| 86580 |
|
17 |
15 |
$0.00 |
| 90647 |
|
16 |
16 |
$0.00 |
| 90723 |
|
17 |
17 |
$0.00 |
| 0094A |
|
12 |
12 |
$0.00 |
| 91313 |
|
100 |
99 |
$0.00 |
| 90700 |
|
230 |
210 |
$0.00 |
| 91321 |
|
185 |
184 |
$0.00 |
| 91300 |
|
191 |
177 |
$0.00 |
| 90714 |
|
222 |
208 |
$0.00 |
| 90670 |
|
334 |
332 |
$0.00 |
| 91311 |
|
122 |
121 |
$0.00 |
| 90734 |
|
296 |
275 |
$0.00 |
| 90710 |
|
117 |
105 |
$0.00 |
| 81002 |
|
31 |
26 |
$0.00 |
| 91312 |
|
86 |
85 |
$0.00 |
| 99173 |
|
18 |
18 |
$0.00 |