| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,387 |
5,866 |
$2.88M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,955 |
3,648 |
$1.75M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,329 |
1,205 |
$703K |
| H0005 |
Alcohol and/or drug services; group counseling by a clinician |
1,326 |
407 |
$633K |
| S0215 |
Non-emergency transportation; mileage, per mile |
11,294 |
4,499 |
$547K |
| D1110 |
Prophylaxis - adult |
659 |
622 |
$328K |
| D0140 |
Limited oral evaluation - problem focused |
448 |
420 |
$238K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
392 |
232 |
$205K |
| 90837 |
Psychotherapy, 53 minutes with patient |
336 |
238 |
$183K |
| D0191 |
|
452 |
386 |
$179K |
| 99215 |
Prolong outpt/office vis |
396 |
345 |
$162K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
319 |
289 |
$150K |
| D0120 |
Periodic oral evaluation - established patient |
298 |
285 |
$149K |
| D1120 |
Prophylaxis - child |
226 |
216 |
$123K |
| 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 |
454 |
380 |
$93K |
| 99442 |
|
151 |
130 |
$66K |
| D0190 |
|
119 |
111 |
$46K |
| 98968 |
|
90 |
40 |
$44K |
| 97803 |
|
57 |
53 |
$26K |
| 90834 |
Psychotherapy, 45 minutes with patient |
55 |
39 |
$26K |
| 90480 |
|
30 |
30 |
$22K |
| D9110 |
|
43 |
41 |
$22K |
| 0064A |
|
61 |
58 |
$20K |
| 0134A |
|
77 |
58 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
17 |
12 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
17 |
$6K |
| 0012A |
|
177 |
172 |
$6K |
| 0011A |
|
197 |
192 |
$5K |
| 99443 |
|
15 |
15 |
$5K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
16 |
15 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
254 |
240 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
22 |
17 |
$279.05 |
| 0001A |
|
12 |
12 |
$40.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$0.00 |
| D1330 |
|
50 |
49 |
$0.00 |