| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
100,019 |
85,018 |
$20.47M |
| 99499 |
|
6,979 |
6,079 |
$93K |
| 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 |
2,085 |
1,889 |
$80K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,845 |
1,558 |
$62K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43,534 |
38,678 |
$46K |
| 0001A |
|
648 |
647 |
$26K |
| 0002A |
|
587 |
587 |
$23K |
| 0012A |
|
386 |
386 |
$15K |
| 3725F |
|
3,032 |
3,003 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,791 |
3,692 |
$14K |
| 0011A |
|
364 |
364 |
$13K |
| 0072A |
|
319 |
319 |
$12K |
| 0071A |
|
326 |
325 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,831 |
9,613 |
$10K |
| 0502F |
|
1,483 |
875 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,613 |
4,526 |
$7K |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
206 |
199 |
$7K |
| 3078F |
|
2,177 |
2,109 |
$6K |
| 0064A |
|
151 |
151 |
$6K |
| 3074F |
|
1,680 |
1,631 |
$5K |
| 3079F |
|
1,524 |
1,493 |
$5K |
| 3077F |
|
1,400 |
1,357 |
$4K |
| 0031A |
|
101 |
101 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,012 |
5,650 |
$4K |
| 3075F |
|
1,001 |
986 |
$3K |
| 90734 |
|
888 |
875 |
$3K |
| 90686 |
|
5,658 |
5,610 |
$3K |
| 0004A |
|
68 |
68 |
$2K |
| 92551 |
|
10,847 |
10,577 |
$2K |
| 99173 |
|
10,882 |
10,628 |
$2K |
| 87428 |
|
137 |
131 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,843 |
2,733 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,453 |
2,268 |
$1K |
| 0054A |
|
41 |
41 |
$1K |
| 3080F |
|
415 |
404 |
$669.38 |
| 3044F |
|
91 |
91 |
$530.00 |
| 0124A |
|
12 |
12 |
$480.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
3,720 |
3,672 |
$230.37 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,977 |
2,734 |
$229.77 |
| 3051F |
|
25 |
25 |
$210.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
443 |
416 |
$152.38 |
| 90656 |
|
691 |
689 |
$149.70 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
837 |
814 |
$137.34 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
6,344 |
6,293 |
$59.00 |
| 81025 |
|
3,080 |
2,935 |
$20.20 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
311 |
274 |
$20.00 |
| 90461 |
|
540 |
526 |
$17.80 |
| 80061 |
Lipid panel |
776 |
703 |
$10.00 |
| D0220 |
Intraoral - periapical first radiographic image |
219 |
213 |
$0.00 |
| 90750 |
|
519 |
519 |
$0.00 |
| 90715 |
|
598 |
598 |
$0.00 |
| D1110 |
Prophylaxis - adult |
80 |
80 |
$0.00 |
| 90633 |
|
105 |
105 |
$0.00 |
| 90682 |
|
464 |
463 |
$0.00 |
| 99397 |
|
168 |
166 |
$0.00 |
| 90648 |
|
323 |
323 |
$0.00 |
| 4004F |
|
13 |
13 |
$0.00 |
| 90670 |
|
300 |
300 |
$0.00 |
| 91300 |
|
194 |
190 |
$0.00 |
| 90662 |
|
155 |
151 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
58 |
58 |
$0.00 |
| 90671 |
|
14 |
14 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 1160F |
|
12 |
12 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
26 |
26 |
$0.00 |
| 90620 |
|
649 |
647 |
$0.00 |
| 81000 |
|
1,058 |
761 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
192 |
179 |
$0.00 |
| 90723 |
|
100 |
100 |
$0.00 |
| 90651 |
|
738 |
735 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
366 |
361 |
$0.00 |
| D1310 |
|
174 |
174 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
332 |
323 |
$0.00 |
| D1330 |
|
317 |
314 |
$0.00 |
| 90680 |
|
88 |
88 |
$0.00 |
| 91301 |
|
53 |
53 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |
| 88142 |
|
138 |
135 |
$0.00 |
| 1036F |
|
247 |
240 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
225 |
220 |
$0.00 |
| 99429 |
|
12 |
12 |
$0.00 |
| 1031F |
|
279 |
272 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
40 |
40 |
$0.00 |
| 93000 |
|
12 |
12 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |
| D0603 |
|
80 |
76 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
46 |
46 |
$0.00 |
| 91307 |
|
23 |
19 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |