| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
25,122 |
20,586 |
$3.79M |
| 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 |
5,969 |
4,793 |
$784K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
4,331 |
2,047 |
$585K |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,154 |
2,916 |
$373K |
| 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 |
8,825 |
6,627 |
$264K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,310 |
5,288 |
$85K |
| 90837 |
Psychotherapy, 53 minutes with patient |
506 |
252 |
$53K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,161 |
690 |
$46K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,949 |
1,481 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
798 |
797 |
$37K |
| D9450 |
|
3,859 |
1,687 |
$34K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,067 |
993 |
$32K |
| D1110 |
Prophylaxis - adult |
1,326 |
698 |
$30K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
909 |
856 |
$28K |
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
403 |
139 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,689 |
2,631 |
$24K |
| 90791 |
Psychiatric diagnostic evaluation |
204 |
203 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,901 |
2,637 |
$21K |
| 99050 |
|
360 |
343 |
$19K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
466 |
216 |
$15K |
| D0120 |
Periodic oral evaluation - established patient |
1,062 |
585 |
$11K |
| 90686 |
|
766 |
764 |
$10K |
| D0210 |
Intraoral - complete series of radiographic images |
347 |
168 |
$9K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
336 |
149 |
$9K |
| D0140 |
Limited oral evaluation - problem focused |
432 |
215 |
$8K |
| D0274 |
Bitewings - four radiographic images |
479 |
258 |
$8K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
102 |
102 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
245 |
244 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
349 |
181 |
$6K |
| D9110 |
|
266 |
134 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
27 |
27 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
679 |
602 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
609 |
310 |
$5K |
| 90688 |
|
371 |
370 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
43 |
43 |
$4K |
| 0012A |
|
95 |
95 |
$4K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
59 |
54 |
$4K |
| 90480 |
|
86 |
86 |
$3K |
| 0124A |
|
72 |
72 |
$3K |
| D1206 |
Topical application of fluoride varnish |
115 |
114 |
$3K |
| 92015 |
Determination of refractive state |
268 |
268 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
266 |
266 |
$3K |
| 90715 |
|
78 |
78 |
$2K |
| 81002 |
|
872 |
770 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
47 |
27 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
25 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$2K |
| D2331 |
|
38 |
16 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
112 |
108 |
$1K |
| D1120 |
Prophylaxis - child |
26 |
26 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
31 |
27 |
$1K |
| 90674 |
|
154 |
154 |
$1K |
| 0011A |
|
24 |
24 |
$1K |
| 0064A |
|
40 |
37 |
$963.27 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
108 |
108 |
$920.70 |
| 93000 |
|
63 |
57 |
$847.16 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
52 |
45 |
$744.07 |
| 0001A |
|
16 |
16 |
$733.92 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
40 |
38 |
$277.30 |
| 71046 |
Radiologic examination, chest; 2 views |
13 |
13 |
$213.07 |
| 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 |
29 |
27 |
$160.20 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
33 |
33 |
$105.96 |
| 90662 |
|
26 |
26 |
$91.36 |
| 91322 |
|
65 |
65 |
$0.57 |
| 91320 |
|
45 |
45 |
$0.34 |
| 91312 |
|
99 |
99 |
$0.00 |
| 90749 |
|
153 |
153 |
$0.00 |
| 90611 |
|
272 |
271 |
$0.00 |
| 91300 |
|
108 |
97 |
$0.00 |
| 90685 |
|
45 |
45 |
$0.00 |
| 91313 |
|
60 |
60 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
44 |
43 |
$0.00 |
| 90750 |
|
12 |
12 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
19 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
203 |
200 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
28 |
28 |
$0.00 |
| 91306 |
|
285 |
280 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
83 |
34 |
$0.00 |
| 91301 |
|
772 |
763 |
$0.00 |
| 91307 |
|
14 |
14 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
12 |
$0.00 |
| 91303 |
|
43 |
43 |
$0.00 |