| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,629 |
3,913 |
$498K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,139 |
880 |
$439.10 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
205 |
164 |
$71.96 |
| 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 |
352 |
244 |
$64.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
193 |
168 |
$44.64 |
| 99000 |
|
729 |
583 |
$41.04 |
| 36415 |
Collection of venous blood by venipuncture |
494 |
390 |
$0.57 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,491 |
1,079 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
924 |
894 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
34 |
26 |
$0.00 |
| 36416 |
|
290 |
234 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
58 |
41 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
88 |
46 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
34 |
32 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
27 |
26 |
$0.00 |
| 90686 |
|
108 |
99 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
31 |
13 |
$0.00 |
| 90715 |
|
58 |
46 |
$0.00 |
| D0190 |
|
300 |
296 |
$0.00 |
| D9996 |
|
476 |
467 |
$0.00 |
| 80305 |
|
55 |
41 |
$0.00 |
| 82947 |
|
237 |
188 |
$0.00 |
| D0330 |
Panoramic radiographic image |
28 |
25 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
88 |
70 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
91 |
76 |
$0.00 |
| 81003 |
|
33 |
30 |
$0.00 |
| D1120 |
Prophylaxis - child |
128 |
116 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
81 |
59 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
15 |
12 |
$0.00 |