| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
289,243 |
254,943 |
$58.24M |
| H0019 |
Behavioral health; long-term residential (non-medical, non-acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem |
9,474 |
618 |
$1.45M |
| 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 |
25,960 |
23,761 |
$811K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
8,847 |
4,229 |
$364K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,026 |
5,740 |
$321K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,087 |
5,081 |
$140K |
| D9999 |
Unspecified adjunctive procedure, by report |
416 |
370 |
$112K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
910 |
511 |
$112K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,472 |
3,471 |
$105K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
954 |
625 |
$103K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,419 |
1,390 |
$102K |
| D0140 |
Limited oral evaluation - problem focused |
3,316 |
3,258 |
$99K |
| 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 |
6,705 |
6,640 |
$90K |
| 92015 |
Determination of refractive state |
4,211 |
4,210 |
$73K |
| H0010 |
Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) |
244 |
87 |
$73K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,011 |
595 |
$71K |
| D0220 |
Intraoral - periapical first radiographic image |
3,447 |
3,341 |
$53K |
| V2020 |
Frames, purchases |
4,787 |
4,785 |
$48K |
| H2017 |
Psychosocial rehabilitation services, per 15 minutes |
2,321 |
690 |
$44K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,235 |
1,196 |
$24K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
127 |
85 |
$18K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
275 |
187 |
$17K |
| H0031 |
Mental health assessment, by non-physician |
180 |
180 |
$16K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
117 |
87 |
$15K |
| H2015 |
Comprehensive community support services, per 15 minutes |
822 |
312 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
305 |
300 |
$11K |
| D4341 |
|
60 |
26 |
$10K |
| 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 |
276 |
143 |
$8K |
| D2140 |
|
81 |
59 |
$5K |
| G0179 |
Physician or allowed practitioner re-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 |
454 |
451 |
$4K |
| D1110 |
Prophylaxis - adult |
281 |
222 |
$4K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
130 |
130 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
297 |
171 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
85 |
45 |
$2K |
| D1120 |
Prophylaxis - child |
326 |
290 |
$1K |
| 92250 |
|
37 |
37 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
114 |
$1K |
| D2330 |
|
17 |
12 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
55 |
53 |
$804.83 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
40 |
24 |
$654.02 |
| 0012A |
|
23 |
23 |
$577.77 |
| T1017 |
Targeted case management, each 15 minutes |
23 |
13 |
$505.96 |
| 80305 |
|
56 |
55 |
$392.35 |
| 90834 |
Psychotherapy, 45 minutes with patient |
17 |
12 |
$297.28 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$250.93 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
106 |
105 |
$220.86 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$191.10 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$112.32 |
| 36415 |
Collection of venous blood by venipuncture |
42 |
41 |
$85.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
19 |
16 |
$83.62 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
27 |
$29.44 |
| 96160 |
|
4,731 |
4,606 |
$0.00 |
| D0330 |
Panoramic radiographic image |
184 |
184 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
105 |
104 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
206 |
206 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,977 |
4,972 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
561 |
549 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
322 |
318 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,788 |
1,783 |
$0.00 |
| 1036F |
|
419 |
414 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
75 |
75 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
154 |
154 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
463 |
463 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
249 |
249 |
$0.00 |
| G9902 |
Patient screened for tobacco use and identified as a tobacco user |
14 |
14 |
$0.00 |
| D1351 |
Sealant - per tooth |
40 |
12 |
$0.00 |
| 96161 |
|
13 |
13 |
$0.00 |