| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
101,805 |
77,855 |
$12.94M |
| 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 |
48,784 |
33,646 |
$2.01M |
| T2022 |
Case management, per month |
10,508 |
8,911 |
$1.56M |
| T2023 |
Targeted case management; per month |
629 |
531 |
$104K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,358 |
1,313 |
$68K |
| D0120 |
Periodic oral evaluation - established patient |
2,427 |
2,351 |
$61K |
| D0330 |
Panoramic radiographic image |
1,457 |
1,410 |
$59K |
| D0220 |
Intraoral - periapical first radiographic image |
4,334 |
4,070 |
$48K |
| D1110 |
Prophylaxis - adult |
936 |
909 |
$45K |
| D1120 |
Prophylaxis - child |
993 |
952 |
$40K |
| D0274 |
Bitewings - four radiographic images |
1,514 |
1,470 |
$38K |
| D0140 |
Limited oral evaluation - problem focused |
1,371 |
1,295 |
$38K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
320 |
221 |
$28K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,870 |
1,814 |
$22K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
317 |
245 |
$21K |
| D1206 |
Topical application of fluoride varnish |
498 |
472 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29,975 |
25,036 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,671 |
5,976 |
$4K |
| 99442 |
|
3,452 |
3,014 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
114 |
95 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
1,338 |
1,246 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,672 |
1,376 |
$946.88 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,819 |
1,179 |
$298.79 |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,056 |
1,792 |
$248.05 |
| 0012A |
|
524 |
511 |
$120.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
859 |
763 |
$108.82 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
3,735 |
3,382 |
$93.84 |
| 0002A |
|
558 |
548 |
$80.00 |
| 0001A |
|
623 |
607 |
$80.00 |
| 0011A |
|
551 |
524 |
$80.00 |
| D0272 |
Bitewings - two radiographic images |
18 |
14 |
$80.00 |
| D0603 |
|
4,999 |
4,284 |
$78.06 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,275 |
1,158 |
$33.44 |
| 81025 |
|
1,948 |
1,760 |
$13.78 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
206 |
196 |
$11.29 |
| 87210 |
|
981 |
872 |
$4.66 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
327 |
306 |
$0.00 |
| D2999 |
|
2,713 |
2,354 |
$0.00 |
| 81002 |
|
630 |
545 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,485 |
3,217 |
$0.00 |
| 0124A |
|
95 |
95 |
$0.00 |
| 90671 |
|
43 |
42 |
$0.00 |
| 90461 |
|
1,280 |
1,156 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 87220 |
|
312 |
246 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
719 |
643 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
510 |
445 |
$0.00 |
| 97803 |
|
390 |
375 |
$0.00 |
| 91300 |
|
985 |
893 |
$0.00 |
| 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 |
107 |
39 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
199 |
168 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
13 |
$0.00 |
| 99188 |
|
78 |
78 |
$0.00 |
| 82274 |
|
30 |
28 |
$0.00 |
| 0004A |
|
120 |
120 |
$0.00 |
| 0071A |
|
66 |
66 |
$0.00 |
| 90670 |
|
155 |
124 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
18 |
15 |
$0.00 |
| 83655 |
|
46 |
46 |
$0.00 |
| 99173 |
|
57 |
56 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
72 |
50 |
$0.00 |
| 90715 |
|
112 |
86 |
$0.00 |
| 90682 |
|
91 |
91 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| 90662 |
|
18 |
18 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
323 |
282 |
$0.00 |
| 91312 |
|
51 |
51 |
$0.00 |
| 99177 |
|
50 |
43 |
$0.00 |
| 91322 |
|
13 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
26 |
26 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,194 |
1,098 |
$0.00 |
| 0064A |
|
213 |
210 |
$0.00 |
| D5899 |
|
305 |
234 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
8,718 |
8,109 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
4,097 |
1,764 |
$0.00 |
| 0072A |
|
49 |
49 |
$0.00 |
| 99443 |
|
220 |
146 |
$0.00 |
| D0602 |
|
331 |
246 |
$0.00 |
| 91301 |
|
852 |
796 |
$0.00 |
| 90686 |
|
815 |
750 |
$0.00 |
| 90651 |
|
100 |
87 |
$0.00 |
| 97802 |
|
323 |
316 |
$0.00 |
| 96127 |
|
39 |
37 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
135 |
122 |
$0.00 |
| 91307 |
|
88 |
83 |
$0.00 |
| 99385 |
|
72 |
64 |
$0.00 |
| D0601 |
|
291 |
233 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
41 |
39 |
$0.00 |
| 90698 |
|
21 |
16 |
$0.00 |
| 92551 |
|
133 |
124 |
$0.00 |
| 91306 |
|
13 |
13 |
$0.00 |
| 85018 |
|
70 |
67 |
$0.00 |
| 99441 |
|
12 |
12 |
$0.00 |
| 90677 |
|
47 |
46 |
$0.00 |
| 90656 |
|
87 |
87 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
12 |
$0.00 |
| 99383 |
|
20 |
12 |
$0.00 |
| 90650 |
|
32 |
17 |
$0.00 |
| 90680 |
|
20 |
16 |
$0.00 |
| 86580 |
|
33 |
29 |
$0.00 |
| D9995 |
|
14 |
13 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
12 |
12 |
$0.00 |
| 99384 |
|
32 |
17 |
$0.00 |