| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
23,082 |
19,146 |
$4.30M |
| 90837 |
Psychotherapy, 53 minutes with patient |
568 |
334 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,142 |
4,451 |
$288.23 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,068 |
3,522 |
$246.49 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
25 |
14 |
$79.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
28 |
$56.91 |
| 90686 |
|
242 |
226 |
$46.11 |
| 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 |
785 |
644 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
393 |
346 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
1,718 |
1,533 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,466 |
872 |
$0.00 |
| 3079F |
|
260 |
251 |
$0.00 |
| 3074F |
|
989 |
935 |
$0.00 |
| 2001F |
|
1,413 |
1,326 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
483 |
467 |
$0.00 |
| 3080F |
|
95 |
93 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
196 |
185 |
$0.00 |
| 3008F |
|
1,286 |
1,214 |
$0.00 |
| 1036F |
|
1,112 |
1,022 |
$0.00 |
| 3044F |
|
53 |
52 |
$0.00 |
| 1034F |
|
109 |
102 |
$0.00 |
| 3075F |
|
154 |
150 |
$0.00 |
| 0012A |
|
35 |
34 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |
| 0011A |
|
38 |
37 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$0.00 |
| 92551 |
|
121 |
119 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
27 |
27 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |
| 0064A |
|
13 |
13 |
$0.00 |
| 90656 |
|
15 |
14 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,798 |
1,578 |
$0.00 |
| 3077F |
|
212 |
192 |
$0.00 |
| D1110 |
Prophylaxis - adult |
612 |
531 |
$0.00 |
| 99173 |
|
78 |
76 |
$0.00 |
| 3078F |
|
942 |
891 |
$0.00 |
| 1159F |
|
536 |
501 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
106 |
100 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
454 |
446 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
74 |
70 |
$0.00 |
| 81003 |
|
12 |
12 |
$0.00 |
| 99001 |
|
63 |
62 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
18 |
18 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
15 |
15 |
$0.00 |
| 4004F |
|
12 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$0.00 |