| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
58,140 |
42,826 |
$11.88M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,887 |
15,001 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,225 |
9,616 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,112 |
3,719 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
583 |
514 |
$1K |
| 96158 |
|
823 |
776 |
$887.84 |
| 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 |
599 |
488 |
$823.49 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
373 |
344 |
$801.14 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,286 |
1,167 |
$765.63 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
1,096 |
1,070 |
$665.05 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
448 |
389 |
$634.10 |
| 0031A |
|
165 |
163 |
$600.00 |
| 99385 |
|
183 |
146 |
$582.36 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
232 |
198 |
$527.65 |
| D7140 |
Extraction, erupted tooth or exposed root |
733 |
339 |
$496.44 |
| 90715 |
|
623 |
520 |
$429.03 |
| 90670 |
|
194 |
167 |
$422.17 |
| 0001A |
|
278 |
274 |
$400.00 |
| 96156 |
|
722 |
683 |
$399.02 |
| 90732 |
|
108 |
90 |
$316.00 |
| 90651 |
|
196 |
159 |
$315.84 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
156 |
122 |
$311.88 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,553 |
1,375 |
$305.68 |
| 0002A |
|
227 |
226 |
$280.00 |
| 90791 |
Psychiatric diagnostic evaluation |
232 |
215 |
$238.18 |
| 96152 |
|
1,007 |
805 |
$236.73 |
| D0140 |
Limited oral evaluation - problem focused |
1,480 |
1,169 |
$220.08 |
| 90746 |
|
73 |
62 |
$123.72 |
| 0012A |
|
19 |
19 |
$120.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
447 |
397 |
$116.70 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,589 |
1,096 |
$116.01 |
| 90750 |
|
388 |
372 |
$115.56 |
| 99386 |
|
66 |
43 |
$112.75 |
| 96154 |
|
16 |
15 |
$97.60 |
| 99215 |
Prolong outpt/office vis |
185 |
166 |
$92.19 |
| D0220 |
Intraoral - periapical first radiographic image |
1,399 |
1,100 |
$89.11 |
| 81025 |
|
215 |
168 |
$86.16 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
120 |
95 |
$77.17 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
399 |
314 |
$67.70 |
| 90688 |
|
969 |
868 |
$32.20 |
| 82962 |
|
218 |
180 |
$24.09 |
| 99177 |
|
223 |
179 |
$22.32 |
| 71046 |
Radiologic examination, chest; 2 views |
59 |
50 |
$20.96 |
| 36415 |
Collection of venous blood by venipuncture |
1,459 |
1,308 |
$13.84 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
496 |
457 |
$12.60 |
| 81003 |
|
287 |
242 |
$5.10 |
| 96153 |
|
32 |
12 |
$4.06 |
| 99173 |
|
331 |
238 |
$2.73 |
| 90686 |
|
1,221 |
1,152 |
$0.74 |
| 1159F |
|
5,403 |
4,308 |
$0.04 |
| 1036F |
|
4,662 |
3,808 |
$0.03 |
| 1125F |
|
2,027 |
1,691 |
$0.01 |
| 1220F |
|
3,275 |
2,870 |
$0.01 |
| 99051 |
|
1,886 |
1,590 |
$0.00 |
| 1158F |
|
2,152 |
1,887 |
$0.00 |
| H0031 |
Mental health assessment, by non-physician |
1,107 |
1,046 |
$0.00 |
| D0270 |
|
118 |
115 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
103 |
103 |
$0.00 |
| 0003A |
|
23 |
23 |
$0.00 |
| 1160F |
|
183 |
127 |
$0.00 |
| 91300 |
|
236 |
212 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
198 |
168 |
$0.00 |
| 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 |
160 |
105 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$0.00 |
| 1003F |
|
94 |
86 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
43 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
17 |
15 |
$0.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
25 |
25 |
$0.00 |
| 2024F |
|
63 |
52 |
$0.00 |
| 90734 |
|
91 |
75 |
$0.00 |
| 90707 |
|
29 |
28 |
$0.00 |
| D1110 |
Prophylaxis - adult |
16 |
15 |
$0.00 |
| 90633 |
|
15 |
13 |
$0.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$0.00 |
| 1126F |
|
1,234 |
960 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
25 |
24 |
$0.00 |
| 1157F |
|
641 |
528 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
108 |
89 |
$0.00 |
| 92551 |
|
227 |
192 |
$0.00 |
| 96127 |
|
1,570 |
1,293 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,586 |
1,158 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
49 |
49 |
$0.00 |
| 91303 |
|
90 |
88 |
$0.00 |
| 99383 |
|
23 |
13 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
39 |
38 |
$0.00 |
| 90716 |
|
29 |
27 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$0.00 |
| 86580 |
|
15 |
13 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
19 |
18 |
$0.00 |
| 0011A |
|
20 |
20 |
$0.00 |
| 76830 |
Ultrasound, transvaginal |
24 |
24 |
$0.00 |
| 92227 |
|
65 |
54 |
$0.00 |
| 90620 |
|
15 |
12 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$0.00 |