| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
115,910 |
76,686 |
$29.81M |
| 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 |
73,481 |
45,920 |
$854K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43,197 |
26,517 |
$742K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
46,967 |
24,673 |
$240K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
13,469 |
8,575 |
$100K |
| 00003 |
Internal/system code - not a standard HCPCS code |
295 |
291 |
$94K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,016 |
2,687 |
$69K |
| 99347 |
|
8,710 |
7,522 |
$65K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,809 |
1,011 |
$55K |
| 99310 |
Prolong nursin fac eval 15m |
6,102 |
4,058 |
$47K |
| D9430 |
|
3,832 |
1,883 |
$44K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,570 |
1,157 |
$42K |
| 99307 |
|
23,798 |
13,819 |
$42K |
| D1110 |
Prophylaxis - adult |
880 |
510 |
$33K |
| Q3014 |
Telehealth originating site facility fee |
2,280 |
1,391 |
$32K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
735 |
378 |
$23K |
| 99306 |
Prolong nursin fac eval 15m |
939 |
720 |
$22K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
3,039 |
1,792 |
$21K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
334 |
224 |
$19K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
705 |
341 |
$19K |
| D0210 |
Intraoral - complete series of radiographic images |
1,193 |
683 |
$18K |
| D1206 |
Topical application of fluoride varnish |
1,453 |
834 |
$17K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
347 |
265 |
$16K |
| 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 |
924 |
884 |
$16K |
| 99305 |
|
1,573 |
1,158 |
$14K |
| D2332 |
|
297 |
126 |
$10K |
| 99334 |
|
4,904 |
4,492 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
2,071 |
1,072 |
$8K |
| 99304 |
|
1,072 |
784 |
$8K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
4,565 |
4,156 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
236 |
144 |
$8K |
| 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 |
242 |
233 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
389 |
260 |
$7K |
| D8670 |
Periodic orthodontic treatment visit |
114 |
70 |
$7K |
| D1120 |
Prophylaxis - child |
266 |
142 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
264 |
146 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
197 |
127 |
$6K |
| D2740 |
Crown - porcelain/ceramic |
20 |
12 |
$5K |
| 90686 |
|
497 |
359 |
$4K |
| 92551 |
|
844 |
567 |
$4K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
108 |
58 |
$4K |
| 90715 |
|
255 |
182 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,246 |
550 |
$4K |
| 99497 |
|
1,068 |
693 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
151 |
66 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
285 |
158 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
66 |
54 |
$3K |
| D0274 |
Bitewings - four radiographic images |
345 |
192 |
$2K |
| 99215 |
Prolong outpt/office vis |
91 |
40 |
$2K |
| 99348 |
|
409 |
342 |
$1K |
| 99342 |
|
34 |
34 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
405 |
323 |
$1K |
| 99335 |
|
569 |
560 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
95 |
57 |
$1K |
| 90710 |
|
39 |
25 |
$1K |
| G0469 |
Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health 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 mental health visit |
29 |
29 |
$916.98 |
| 81002 |
|
998 |
749 |
$724.57 |
| D0330 |
Panoramic radiographic image |
87 |
46 |
$722.00 |
| D0270 |
|
648 |
351 |
$705.00 |
| D0272 |
Bitewings - two radiographic images |
101 |
71 |
$403.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
402 |
344 |
$362.86 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
99 |
68 |
$344.15 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
64 |
28 |
$298.37 |
| 99315 |
|
55 |
31 |
$281.60 |
| 99173 |
|
1,002 |
860 |
$280.92 |
| 85018 |
|
377 |
273 |
$252.13 |
| 99205 |
Prolong outpt/office vis |
22 |
13 |
$248.10 |
| 90651 |
|
22 |
13 |
$168.75 |
| G0180 |
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care |
16 |
12 |
$146.14 |
| 81025 |
|
68 |
44 |
$105.67 |
| 99316 |
|
52 |
39 |
$93.20 |
| 81000 |
|
251 |
233 |
$48.73 |
| 99000 |
|
48 |
29 |
$47.19 |
| 90713 |
|
14 |
12 |
$40.50 |
| 81007 |
|
16 |
13 |
$5.58 |
| 82948 |
|
17 |
15 |
$2.71 |
| 3074F |
|
1,389 |
935 |
$0.00 |
| 3079F |
|
535 |
377 |
$0.00 |
| 3075F |
|
398 |
287 |
$0.00 |
| D1310 |
|
17 |
17 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
36 |
36 |
$0.00 |
| 3080F |
|
168 |
110 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
27 |
14 |
$0.00 |
| D0603 |
|
22 |
12 |
$0.00 |
| D1330 |
|
17 |
17 |
$0.00 |
| 3078F |
|
1,335 |
930 |
$0.00 |
| 3077F |
|
393 |
249 |
$0.00 |
| 99337 |
|
36 |
36 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
301 |
293 |
$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 |
48 |
48 |
$0.00 |