| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
100,033 |
83,563 |
$8.70M |
| T2022 |
Case management, per month |
39,549 |
36,806 |
$5.00M |
| T2023 |
Targeted case management; per month |
11,328 |
10,688 |
$2.89M |
| D0330 |
Panoramic radiographic image |
1,180 |
1,141 |
$54K |
| D0120 |
Periodic oral evaluation - established patient |
1,782 |
1,750 |
$42K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
544 |
531 |
$35K |
| D1110 |
Prophylaxis - adult |
577 |
558 |
$32K |
| D0140 |
Limited oral evaluation - problem focused |
967 |
923 |
$32K |
| D0274 |
Bitewings - four radiographic images |
772 |
751 |
$26K |
| D0220 |
Intraoral - periapical first radiographic image |
323 |
309 |
$4K |
| D1206 |
Topical application of fluoride varnish |
95 |
75 |
$974.18 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,229 |
9,026 |
$592.80 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55,215 |
44,335 |
$426.56 |
| 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 |
14,604 |
6,773 |
$325.23 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,889 |
1,545 |
$116.01 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,745 |
5,638 |
$35.60 |
| 91301 |
|
1,346 |
1,305 |
$0.00 |
| 90688 |
|
2,399 |
1,990 |
$0.00 |
| 82962 |
|
3,476 |
2,825 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
7,449 |
7,006 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,564 |
5,368 |
$0.00 |
| 0011A |
|
669 |
666 |
$0.00 |
| 92551 |
|
1,255 |
1,220 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
846 |
476 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
267 |
236 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
452 |
294 |
$0.00 |
| 86580 |
|
178 |
169 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,485 |
1,318 |
$0.00 |
| 99000 |
|
510 |
483 |
$0.00 |
| 91306 |
|
119 |
119 |
$0.00 |
| 11055 |
|
187 |
165 |
$0.00 |
| 96127 |
|
1,576 |
1,534 |
$0.00 |
| 98925 |
|
24 |
18 |
$0.00 |
| 91307 |
|
68 |
65 |
$0.00 |
| 90686 |
|
480 |
402 |
$0.00 |
| 0012A |
|
632 |
630 |
$0.00 |
| 90732 |
|
103 |
75 |
$0.00 |
| 90647 |
|
42 |
41 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
56 |
50 |
$0.00 |
| 0064A |
|
153 |
153 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
14 |
$0.00 |
| D5899 |
|
231 |
178 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
29 |
25 |
$0.00 |
| D0170 |
|
17 |
14 |
$0.00 |
| 90723 |
|
24 |
24 |
$0.00 |
| 93000 |
|
12 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
28 |
25 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
52 |
30 |
$0.00 |
| D9995 |
|
53 |
47 |
$0.00 |
| 90474 |
|
45 |
43 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 81002 |
|
4,118 |
3,494 |
$0.00 |
| 11721 |
|
4,352 |
3,757 |
$0.00 |
| 81025 |
|
2,499 |
2,397 |
$0.00 |
| 90715 |
|
341 |
321 |
$0.00 |
| 11056 |
|
1,025 |
871 |
$0.00 |
| D2999 |
|
529 |
507 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,538 |
1,475 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
556 |
528 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
268 |
248 |
$0.00 |
| 90670 |
|
360 |
292 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
690 |
672 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
858 |
639 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
856 |
570 |
$0.00 |
| 99173 |
|
1,480 |
1,448 |
$0.00 |
| 87210 |
|
885 |
558 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
721 |
694 |
$0.00 |
| D0191 |
|
222 |
220 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
342 |
318 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
253 |
185 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
255 |
242 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
263 |
224 |
$0.00 |
| 91300 |
|
14 |
14 |
$0.00 |
| 99201 |
|
39 |
38 |
$0.00 |
| 90633 |
|
31 |
29 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
39 |
38 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
33 |
27 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$0.00 |
| 0071A |
|
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
113 |
112 |
$0.00 |
| 90734 |
|
17 |
14 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
174 |
107 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
21 |
12 |
$0.00 |
| 86703 |
|
18 |
15 |
$0.00 |