| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
108,093 |
69,820 |
$19.28M |
| T1016 |
Case management, each 15 minutes |
10,480 |
8,513 |
$179K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
36,370 |
17,241 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,094 |
15,013 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,599 |
18,742 |
$35K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,599 |
1,510 |
$20K |
| H0031 |
Mental health assessment, by non-physician |
3,589 |
3,294 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,008 |
1,820 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,139 |
1,046 |
$4K |
| 96156 |
|
1,259 |
1,034 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
492 |
427 |
$3K |
| 97802 |
|
1,813 |
1,538 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
423 |
354 |
$1K |
| 99442 |
|
94 |
90 |
$984.38 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,196 |
1,943 |
$830.62 |
| 97803 |
|
835 |
588 |
$753.66 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
185 |
154 |
$677.25 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
204 |
195 |
$421.92 |
| 99215 |
Prolong outpt/office vis |
133 |
124 |
$245.16 |
| 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 |
60 |
47 |
$195.15 |
| 90791 |
Psychiatric diagnostic evaluation |
749 |
700 |
$149.58 |
| 90686 |
|
825 |
725 |
$129.88 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
631 |
569 |
$110.77 |
| 0001A |
|
234 |
174 |
$104.00 |
| 93000 |
|
62 |
59 |
$59.66 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
361 |
240 |
$31.75 |
| 0011A |
|
177 |
169 |
$16.94 |
| 81002 |
|
157 |
133 |
$16.84 |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,036 |
1,962 |
$15.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
116 |
102 |
$13.91 |
| 81025 |
|
307 |
249 |
$7.91 |
| D0330 |
Panoramic radiographic image |
39 |
39 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
517 |
342 |
$0.00 |
| 3077F |
|
431 |
402 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
645 |
579 |
$0.00 |
| 4274F |
|
818 |
724 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,876 |
1,634 |
$0.00 |
| 3078F |
|
2,386 |
2,182 |
$0.00 |
| D1354 |
|
2,846 |
469 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
466 |
352 |
$0.00 |
| D1120 |
Prophylaxis - child |
759 |
673 |
$0.00 |
| 1160F |
|
2,957 |
2,639 |
$0.00 |
| D1321 |
|
128 |
124 |
$0.00 |
| 1159F |
|
2,955 |
2,637 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
319 |
283 |
$0.00 |
| 99001 |
|
18 |
17 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
59 |
59 |
$0.00 |
| 91300 |
|
133 |
54 |
$0.00 |
| 4040F |
|
207 |
175 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |
| 0054A |
|
37 |
37 |
$0.00 |
| 0124A |
|
76 |
70 |
$0.00 |
| 90746 |
|
12 |
12 |
$0.00 |
| 80305 |
|
62 |
48 |
$0.00 |
| D0190 |
|
15 |
13 |
$0.00 |
| 90662 |
|
13 |
13 |
$0.00 |
| 0002A |
|
105 |
91 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
15 |
$0.00 |
| 96160 |
|
33 |
32 |
$0.00 |
| D0270 |
|
23 |
17 |
$0.00 |
| 91320 |
|
79 |
37 |
$0.00 |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
593 |
498 |
$0.00 |
| 4010F |
|
485 |
414 |
$0.00 |
| 1125F |
|
186 |
177 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
2,155 |
1,929 |
$0.00 |
| D1310 |
|
889 |
685 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
70 |
52 |
$0.00 |
| D0603 |
|
455 |
398 |
$0.00 |
| D1330 |
|
840 |
649 |
$0.00 |
| 2000F |
|
3,697 |
3,270 |
$0.00 |
| 3351F |
|
1,542 |
1,409 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,301 |
1,168 |
$0.00 |
| 1036F |
|
2,775 |
2,465 |
$0.00 |
| 2010F |
|
3,880 |
3,427 |
$0.00 |
| 3074F |
|
2,785 |
2,528 |
$0.00 |
| 2001F |
|
3,767 |
3,336 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
205 |
114 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,444 |
1,125 |
$0.00 |
| D1320 |
|
447 |
427 |
$0.00 |
| 3008F |
|
3,556 |
3,153 |
$0.00 |
| 1126F |
|
1,305 |
1,227 |
$0.00 |
| 96127 |
|
30 |
27 |
$0.00 |
| 0031A |
|
35 |
31 |
$0.00 |
| 1034F |
|
370 |
323 |
$0.00 |
| 4037F |
|
124 |
122 |
$0.00 |
| 3079F |
|
1,060 |
1,000 |
$0.00 |
| 87428 |
|
372 |
300 |
$0.00 |
| 96150 |
|
418 |
286 |
$0.00 |
| 3075F |
|
412 |
393 |
$0.00 |
| 3080F |
|
137 |
127 |
$0.00 |
| 90656 |
|
178 |
97 |
$0.00 |
| D9995 |
|
193 |
179 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
57 |
54 |
$0.00 |
| D0602 |
|
41 |
30 |
$0.00 |
| 90480 |
|
73 |
35 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
96 |
74 |
$0.00 |
| 0012A |
|
124 |
121 |
$0.00 |
| D1351 |
Sealant - per tooth |
32 |
12 |
$0.00 |