| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,609 |
19,717 |
$4.86M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,482 |
10,451 |
$489K |
| 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 |
8,072 |
6,576 |
$398K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,553 |
8,418 |
$304K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,083 |
1,758 |
$122K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,741 |
1,088 |
$49K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
521 |
391 |
$44K |
| 90832 |
Psychotherapy, 30 minutes with patient |
964 |
657 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
632 |
574 |
$20K |
| 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 |
270 |
144 |
$15K |
| 80305 |
|
207 |
132 |
$14K |
| D0140 |
Limited oral evaluation - problem focused |
324 |
314 |
$5K |
| G0008 |
Administration of influenza virus vaccine |
605 |
590 |
$5K |
| D1206 |
Topical application of fluoride varnish |
313 |
296 |
$4K |
| 90791 |
Psychiatric diagnostic evaluation |
66 |
57 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
769 |
726 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
69 |
69 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
511 |
248 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
37 |
$799.68 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
272 |
270 |
$478.57 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
541 |
508 |
$451.07 |
| D1110 |
Prophylaxis - adult |
561 |
534 |
$374.25 |
| 99406 |
|
44 |
42 |
$337.11 |
| 99000 |
|
71 |
70 |
$286.20 |
| D9110 |
|
347 |
333 |
$216.35 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
34 |
34 |
$177.29 |
| 90686 |
|
226 |
217 |
$23.15 |
| 97803 |
|
472 |
462 |
$0.63 |
| D0120 |
Periodic oral evaluation - established patient |
185 |
175 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
164 |
131 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
34 |
34 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
151 |
149 |
$0.00 |
| 97802 |
|
88 |
88 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
27 |
14 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$0.00 |
| 90656 |
|
36 |
36 |
$0.00 |
| D1120 |
Prophylaxis - child |
137 |
133 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
425 |
396 |
$0.00 |
| D0330 |
Panoramic radiographic image |
104 |
87 |
$0.00 |
| 81003 |
|
24 |
24 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
13 |
12 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
32 |
13 |
$0.00 |
| 99188 |
|
125 |
125 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| D0270 |
|
15 |
15 |
$0.00 |