| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,457 |
5,108 |
$1.09M |
| D0999 |
Unspecified diagnostic procedure, by report |
1,535 |
1,398 |
$229K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,017 |
2,563 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,567 |
2,120 |
$88K |
| 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 |
654 |
543 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
438 |
398 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
80 |
78 |
$5K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
234 |
209 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
511 |
453 |
$3K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
175 |
151 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
25 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
250 |
226 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$830.30 |
| 0012A |
|
26 |
25 |
$709.75 |
| 81002 |
|
458 |
337 |
$669.62 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
314 |
290 |
$622.82 |
| 87081 |
|
194 |
175 |
$520.34 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
34 |
$458.70 |
| 81025 |
|
123 |
111 |
$404.88 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
364 |
336 |
$404.77 |
| 84443 |
Thyroid stimulating hormone (TSH) |
87 |
82 |
$378.58 |
| 80053 |
Comprehensive metabolic panel |
207 |
198 |
$366.12 |
| 90461 |
|
70 |
63 |
$360.22 |
| 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 |
26 |
26 |
$338.00 |
| 0011A |
|
15 |
15 |
$237.16 |
| 80061 |
Lipid panel |
166 |
158 |
$206.25 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
43 |
41 |
$161.84 |
| D0120 |
Periodic oral evaluation - established patient |
478 |
467 |
$115.40 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
32 |
29 |
$88.44 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
32 |
29 |
$88.44 |
| 90686 |
|
350 |
338 |
$75.36 |
| 96160 |
|
31 |
31 |
$65.78 |
| D1208 |
Topical application of fluoride, excluding varnish |
612 |
590 |
$58.80 |
| D1120 |
Prophylaxis - child |
250 |
236 |
$56.00 |
| D1110 |
Prophylaxis - adult |
113 |
111 |
$40.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
28 |
24 |
$33.90 |
| 81001 |
|
34 |
29 |
$31.92 |
| 84436 |
|
12 |
12 |
$23.08 |
| 84479 |
|
12 |
12 |
$21.72 |
| 86803 |
|
13 |
12 |
$11.99 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
54 |
50 |
$10.94 |
| 3725F |
|
313 |
240 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
159 |
156 |
$0.00 |
| 1160F |
|
288 |
221 |
$0.00 |
| 0502F |
|
72 |
43 |
$0.00 |
| 3078F |
|
570 |
444 |
$0.00 |
| 1159F |
|
704 |
535 |
$0.00 |
| 91300 |
|
13 |
12 |
$0.00 |
| 92552 |
|
46 |
46 |
$0.00 |
| 99173 |
|
143 |
141 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
48 |
41 |
$0.00 |
| 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 |
18 |
18 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
13 |
13 |
$0.00 |
| 3008F |
|
754 |
566 |
$0.00 |
| D0603 |
|
695 |
667 |
$0.00 |
| D0602 |
|
18 |
18 |
$0.00 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
45 |
44 |
$0.00 |
| 3075F |
|
17 |
15 |
$0.00 |
| 3079F |
|
75 |
64 |
$0.00 |
| 3044F |
|
176 |
154 |
$0.00 |
| 1126F |
|
50 |
44 |
$0.00 |
| 1036F |
|
641 |
455 |
$0.00 |
| 3074F |
|
618 |
464 |
$0.00 |
| D1330 |
|
195 |
181 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
75 |
74 |
$0.00 |
| 91301 |
|
47 |
46 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
16 |
16 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
26 |
12 |
$0.00 |