| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
19,311 |
12,066 |
$3.64M |
| 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 |
3,385 |
2,838 |
$181K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,813 |
4,461 |
$45K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,573 |
5,565 |
$24K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
179 |
159 |
$10K |
| D1110 |
Prophylaxis - adult |
565 |
495 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
2,728 |
2,515 |
$3K |
| 99000 |
|
2,321 |
1,909 |
$2K |
| 99215 |
Prolong outpt/office vis |
337 |
292 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
504 |
414 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,011 |
617 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
230 |
222 |
$2K |
| 0031A |
|
44 |
43 |
$1K |
| 0064A |
|
32 |
32 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,655 |
1,234 |
$1K |
| D1120 |
Prophylaxis - child |
413 |
373 |
$1K |
| 0011A |
|
21 |
21 |
$783.09 |
| D0120 |
Periodic oral evaluation - established patient |
369 |
343 |
$761.06 |
| 0012A |
|
21 |
21 |
$745.80 |
| D0220 |
Intraoral - periapical first radiographic image |
479 |
401 |
$740.34 |
| 90686 |
|
168 |
163 |
$472.71 |
| 90662 |
|
92 |
88 |
$300.07 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
216 |
167 |
$260.92 |
| D1206 |
Topical application of fluoride varnish |
497 |
451 |
$152.48 |
| D0274 |
Bitewings - four radiographic images |
140 |
97 |
$94.55 |
| D7140 |
Extraction, erupted tooth or exposed root |
132 |
77 |
$80.18 |
| 80305 |
|
227 |
194 |
$59.41 |
| 90661 |
|
12 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
67 |
39 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
13 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
41 |
33 |
$0.00 |
| 90688 |
|
39 |
39 |
$0.00 |
| 91301 |
|
54 |
54 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
178 |
175 |
$0.00 |
| D0601 |
|
26 |
26 |
$0.00 |
| 91303 |
|
44 |
43 |
$0.00 |
| 91306 |
|
32 |
32 |
$0.00 |
| D1351 |
Sealant - per tooth |
107 |
26 |
$0.00 |