| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
30,520 |
25,200 |
$3.56M |
| D0220 |
Intraoral - periapical first radiographic image |
227 |
221 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
107 |
87 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
54 |
54 |
$2K |
| D0274 |
Bitewings - four radiographic images |
42 |
42 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,619 |
10,281 |
$604.63 |
| D0330 |
Panoramic radiographic image |
20 |
12 |
$530.10 |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$434.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
637 |
414 |
$370.50 |
| 90791 |
Psychiatric diagnostic evaluation |
367 |
348 |
$242.96 |
| 90834 |
Psychotherapy, 45 minutes with patient |
51 |
44 |
$82.58 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,306 |
1,251 |
$75.17 |
| 90832 |
Psychotherapy, 30 minutes with patient |
127 |
104 |
$59.17 |
| 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 |
5,531 |
3,165 |
$39.42 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,094 |
1,037 |
$8.63 |
| D0999 |
Unspecified diagnostic procedure, by report |
2,072 |
1,883 |
$0.00 |
| 90686 |
|
692 |
686 |
$0.00 |
| 0012A |
|
426 |
425 |
$0.00 |
| 91301 |
|
717 |
688 |
$0.00 |
| 0064A |
|
166 |
166 |
$0.00 |
| 0011A |
|
466 |
454 |
$0.00 |
| 90656 |
|
150 |
148 |
$0.00 |
| D0603 |
|
587 |
466 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,819 |
3,565 |
$0.00 |
| 0072A |
|
32 |
31 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
16 |
16 |
$0.00 |
| 0001A |
|
205 |
203 |
$0.00 |
| T2022 |
Case management, per month |
305 |
154 |
$0.00 |
| 91307 |
|
38 |
36 |
$0.00 |
| 92551 |
|
32 |
30 |
$0.00 |
| 0002A |
|
160 |
156 |
$0.00 |
| 0004A |
|
46 |
46 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
681 |
639 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
61 |
$0.00 |
| 87210 |
|
69 |
68 |
$0.00 |
| 91300 |
|
382 |
337 |
$0.00 |
| 99442 |
|
12 |
12 |
$0.00 |
| D2999 |
|
404 |
358 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,035 |
921 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
220 |
153 |
$0.00 |
| 0124A |
|
36 |
36 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
56 |
55 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$0.00 |
| 0071A |
|
33 |
33 |
$0.00 |
| 81025 |
|
59 |
50 |
$0.00 |
| 90662 |
|
31 |
29 |
$0.00 |
| 90682 |
|
91 |
87 |
$0.00 |
| 0013A |
|
21 |
21 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$0.00 |
| 99173 |
|
48 |
45 |
$0.00 |
| 82274 |
|
12 |
12 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
55 |
48 |
$0.00 |
| 91312 |
|
24 |
24 |
$0.00 |
| 90461 |
|
16 |
13 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
58 |
57 |
$0.00 |
| 81002 |
|
13 |
12 |
$0.00 |
| 91322 |
|
12 |
12 |
$0.00 |
| 87220 |
|
13 |
13 |
$0.00 |