| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,554 |
23,270 |
$3.54M |
| 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 |
22,887 |
15,351 |
$991K |
| T2022 |
Case management, per month |
2,216 |
1,971 |
$283K |
| D1110 |
Prophylaxis - adult |
712 |
610 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,649 |
12,273 |
$19K |
| D0120 |
Periodic oral evaluation - established patient |
647 |
553 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,219 |
6,757 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
63 |
55 |
$1K |
| D0274 |
Bitewings - four radiographic images |
16 |
14 |
$562.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
12 |
$439.50 |
| D0140 |
Limited oral evaluation - problem focused |
13 |
12 |
$262.36 |
| 0011A |
|
449 |
412 |
$90.82 |
| 0012A |
|
295 |
279 |
$80.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,478 |
1,419 |
$67.54 |
| 36415 |
Collection of venous blood by venipuncture |
2,380 |
2,268 |
$19.12 |
| 90686 |
|
1,194 |
981 |
$15.22 |
| 81002 |
|
120 |
109 |
$0.00 |
| D2999 |
|
350 |
327 |
$0.00 |
| 86689 |
|
149 |
133 |
$0.00 |
| 92015 |
Determination of refractive state |
104 |
73 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
17 |
13 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
217 |
212 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
80 |
79 |
$0.00 |
| 90658 |
|
285 |
281 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
77 |
64 |
$0.00 |
| 91320 |
|
48 |
48 |
$0.00 |
| 90756 |
|
225 |
176 |
$0.00 |
| 91322 |
|
70 |
68 |
$0.00 |
| 90750 |
|
17 |
14 |
$0.00 |
| 91313 |
|
29 |
29 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
22 |
19 |
$0.00 |
| 81025 |
|
42 |
41 |
$0.00 |
| 99000 |
|
634 |
606 |
$0.00 |
| 90688 |
|
645 |
550 |
$0.00 |
| 82950 |
|
14 |
12 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
923 |
884 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
780 |
762 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
970 |
676 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
333 |
302 |
$0.00 |
| 91301 |
|
580 |
530 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
185 |
148 |
$0.00 |
| 0064A |
|
369 |
242 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
757 |
317 |
$0.00 |
| 0134A |
|
23 |
18 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
30 |
17 |
$0.00 |
| 90480 |
|
118 |
116 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
58 |
52 |
$0.00 |
| D1330 |
|
28 |
28 |
$0.00 |
| 90732 |
|
35 |
23 |
$0.00 |