| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
15,089 |
8,333 |
$5.94M |
| 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 |
1,160 |
774 |
$252K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,345 |
1,305 |
$185K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,627 |
4,114 |
$162K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,929 |
1,631 |
$83K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,317 |
779 |
$67K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
200 |
158 |
$56K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
262 |
196 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,562 |
1,002 |
$20K |
| 99000 |
|
270 |
183 |
$13K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
45 |
24 |
$11K |
| 99443 |
|
375 |
204 |
$10K |
| A0425 |
Ground mileage, per statute mile |
67 |
40 |
$9K |
| 99001 |
|
41 |
36 |
$8K |
| D0140 |
Limited oral evaluation - problem focused |
132 |
110 |
$7K |
| 98940 |
|
72 |
51 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
98 |
90 |
$2K |
| 0002A |
|
98 |
79 |
$1K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
13 |
12 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
83 |
59 |
$1K |
| 0001A |
|
107 |
77 |
$960.87 |
| D1206 |
Topical application of fluoride varnish |
239 |
234 |
$907.85 |
| D0220 |
Intraoral - periapical first radiographic image |
44 |
42 |
$797.18 |
| D0120 |
Periodic oral evaluation - established patient |
23 |
22 |
$700.00 |
| D1330 |
|
234 |
229 |
$576.00 |
| 36415 |
Collection of venous blood by venipuncture |
635 |
546 |
$485.57 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$414.00 |
| G0008 |
Administration of influenza virus vaccine |
41 |
39 |
$410.46 |
| 80305 |
|
372 |
198 |
$400.16 |
| 0011A |
|
14 |
13 |
$181.19 |
| 90686 |
|
52 |
41 |
$118.52 |
| 0012A |
|
32 |
27 |
$56.78 |
| D0190 |
|
361 |
318 |
$13.34 |
| D1110 |
Prophylaxis - adult |
54 |
54 |
$0.00 |
| 92015 |
Determination of refractive state |
24 |
13 |
$0.00 |
| 91300 |
|
256 |
190 |
$0.00 |
| D0330 |
Panoramic radiographic image |
13 |
13 |
$0.00 |
| 91301 |
|
127 |
107 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
40 |
39 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
16 |
15 |
$0.00 |