| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
58,024 |
37,481 |
$3.16M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31,182 |
16,788 |
$779K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
39,140 |
20,068 |
$689K |
| 99406 |
|
18,422 |
9,748 |
$59K |
| 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 |
4,021 |
3,179 |
$40K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,709 |
1,004 |
$37K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,278 |
830 |
$35K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,236 |
2,014 |
$26K |
| 99215 |
Prolong outpt/office vis |
799 |
407 |
$22K |
| S9470 |
Nutritional counseling, dietitian visit |
15,882 |
10,231 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
630 |
350 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,633 |
1,092 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
715 |
411 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
584 |
297 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,619 |
985 |
$14K |
| D1110 |
Prophylaxis - adult |
1,602 |
1,049 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
2,770 |
1,566 |
$10K |
| 90837 |
Psychotherapy, 53 minutes with patient |
413 |
78 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
745 |
470 |
$8K |
| D0274 |
Bitewings - four radiographic images |
1,461 |
902 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,212 |
1,836 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,230 |
656 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
279 |
183 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
216 |
121 |
$7K |
| 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 |
1,166 |
1,016 |
$6K |
| D1120 |
Prophylaxis - child |
1,066 |
746 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
176 |
81 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
298 |
162 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
3,519 |
2,025 |
$5K |
| D0330 |
Panoramic radiographic image |
326 |
196 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
212 |
88 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
386 |
245 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,039 |
348 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
321 |
170 |
$2K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
534 |
263 |
$2K |
| 93000 |
|
227 |
138 |
$2K |
| 90674 |
|
129 |
68 |
$2K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
38 |
29 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
105 |
64 |
$2K |
| 90688 |
|
237 |
121 |
$1K |
| D0272 |
Bitewings - two radiographic images |
803 |
514 |
$1K |
| 99205 |
Prolong outpt/office vis |
19 |
14 |
$1K |
| T2003 |
Non-emergency transportation; encounter/trip |
121 |
29 |
$893.00 |
| D0120 |
Periodic oral evaluation - established patient |
956 |
575 |
$888.16 |
| D2140 |
|
398 |
218 |
$880.00 |
| D1206 |
Topical application of fluoride varnish |
1,149 |
842 |
$840.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
80 |
51 |
$617.62 |
| 90756 |
|
69 |
37 |
$591.97 |
| 90658 |
|
149 |
74 |
$439.03 |
| 90832 |
Psychotherapy, 30 minutes with patient |
65 |
27 |
$421.30 |
| 81002 |
|
1,092 |
539 |
$354.25 |
| 90461 |
|
1,225 |
389 |
$320.00 |
| D0270 |
|
78 |
39 |
$125.00 |
| 90733 |
|
22 |
14 |
$40.00 |
| 90633 |
|
40 |
33 |
$20.00 |
| 99172 |
|
30 |
15 |
$19.88 |
| 3077F |
|
1,071 |
659 |
$0.00 |
| 2014F |
|
2,645 |
1,825 |
$0.00 |
| S0613 |
Annual gynecological examination; clinical breast examination without pelvic evaluation |
43 |
37 |
$0.00 |
| 99408 |
|
183 |
104 |
$0.00 |
| 1003F |
|
35 |
33 |
$0.00 |
| 3078F |
|
3,266 |
1,861 |
$0.00 |
| 98960 |
|
587 |
497 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
271 |
184 |
$0.00 |
| 97803 |
|
355 |
305 |
$0.00 |
| 90670 |
|
115 |
99 |
$0.00 |
| 81025 |
|
22 |
12 |
$0.00 |
| 82947 |
|
15 |
12 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
23 |
13 |
$0.00 |
| 1000F |
|
10,775 |
7,896 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,268 |
3,949 |
$0.00 |
| 3079F |
|
4,115 |
2,375 |
$0.00 |
| 1036F |
|
702 |
406 |
$0.00 |
| 3008F |
|
7,772 |
4,387 |
$0.00 |
| 99000 |
|
1,265 |
690 |
$0.00 |
| 3075F |
|
1,326 |
789 |
$0.00 |
| 3074F |
|
5,244 |
2,924 |
$0.00 |
| 3080F |
|
992 |
581 |
$0.00 |
| 3044F |
|
128 |
121 |
$0.00 |
| 90651 |
|
123 |
96 |
$0.00 |
| 90686 |
|
158 |
116 |
$0.00 |
| S9452 |
Nutrition classes, non-physician provider, per session |
324 |
285 |
$0.00 |
| 90698 |
|
88 |
77 |
$0.00 |
| 90744 |
|
33 |
24 |
$0.00 |
| 4010F |
|
326 |
164 |
$0.00 |
| 97802 |
|
66 |
50 |
$0.00 |
| 90647 |
|
16 |
13 |
$0.00 |
| 90619 |
|
18 |
12 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |