| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
307 |
301 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,458 |
4,201 |
$723.80 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
486 |
345 |
$177.53 |
| 90688 |
|
832 |
809 |
$171.00 |
| 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 |
12,412 |
9,186 |
$70.40 |
| 90832 |
Psychotherapy, 30 minutes with patient |
33,006 |
16,451 |
$54.45 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45,686 |
37,177 |
$41.33 |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,581 |
5,573 |
$0.00 |
| 87430 |
|
578 |
546 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,523 |
12,823 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,630 |
2,604 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
2,261 |
2,096 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,244 |
1,166 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,840 |
2,463 |
$0.00 |
| 90677 |
|
62 |
55 |
$0.00 |
| 96150 |
|
229 |
214 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,089 |
1,082 |
$0.00 |
| 94010 |
|
182 |
155 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
747 |
745 |
$0.00 |
| 82962 |
|
3,613 |
3,154 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
3,419 |
3,298 |
$0.00 |
| 88142 |
|
236 |
226 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
1,360 |
1,345 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
680 |
540 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
328 |
287 |
$0.00 |
| 90636 |
|
237 |
231 |
$0.00 |
| 90651 |
|
295 |
277 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
3,804 |
1,728 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
49 |
47 |
$0.00 |
| 84704 |
|
241 |
230 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
294 |
282 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
142 |
81 |
$0.00 |
| 93000 |
|
417 |
392 |
$0.00 |
| 90480 |
|
35 |
33 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
426 |
357 |
$0.00 |
| 99441 |
|
54 |
54 |
$0.00 |
| 90732 |
|
64 |
64 |
$0.00 |
| D2331 |
|
52 |
39 |
$0.00 |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
134 |
79 |
$0.00 |
| D2330 |
|
56 |
45 |
$0.00 |
| 98967 |
|
243 |
174 |
$0.00 |
| 90839 |
|
19 |
18 |
$0.00 |
| 99443 |
|
14 |
14 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
12 |
12 |
$0.00 |
| 96127 |
|
49 |
45 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
177 |
168 |
$0.00 |
| 99000 |
|
101 |
99 |
$0.00 |
| D1351 |
Sealant - per tooth |
40 |
12 |
$0.00 |
| 90686 |
|
21 |
19 |
$0.00 |
| 90674 |
|
89 |
86 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
12 |
12 |
$0.00 |
| 90673 |
|
16 |
16 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
260 |
247 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,172 |
5,339 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
9,272 |
3,772 |
$0.00 |
| D1110 |
Prophylaxis - adult |
3,108 |
3,062 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
423 |
405 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,384 |
3,109 |
$0.00 |
| 81002 |
|
2,263 |
2,042 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
3,241 |
3,111 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,072 |
1,023 |
$0.00 |
| D0330 |
Panoramic radiographic image |
1,137 |
1,127 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
576 |
424 |
$0.00 |
| 90461 |
|
55 |
54 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
452 |
444 |
$0.00 |
| 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 |
936 |
587 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
985 |
928 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
24,929 |
5,281 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
4,241 |
3,992 |
$0.00 |
| D2332 |
|
16 |
14 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
102 |
102 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
1,250 |
1,134 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
655 |
505 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
1,594 |
1,580 |
$0.00 |
| D0270 |
|
392 |
387 |
$0.00 |
| 98966 |
|
128 |
114 |
$0.00 |
| 90715 |
|
579 |
535 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
160 |
152 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
50 |
43 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
85 |
84 |
$0.00 |
| 90785 |
|
5,750 |
2,403 |
$0.00 |
| 81025 |
|
130 |
122 |
$0.00 |
| 90682 |
|
710 |
681 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
555 |
517 |
$0.00 |
| D4910 |
|
218 |
214 |
$0.00 |
| D0431 |
|
34 |
33 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
21 |
13 |
$0.00 |
| 90658 |
|
45 |
45 |
$0.00 |
| 90750 |
|
78 |
78 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
12 |
12 |
$0.00 |
| D1354 |
|
160 |
65 |
$0.00 |
| 96160 |
|
23 |
18 |
$0.00 |
| 91320 |
|
18 |
16 |
$0.00 |
| 90662 |
|
71 |
63 |
$0.00 |
| DRADF |
|
16 |
15 |
$0.00 |
| 90756 |
|
135 |
129 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
27 |
$0.00 |
| 99408 |
|
13 |
13 |
$0.00 |
| 99442 |
|
33 |
33 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
50 |
42 |
$0.00 |
| D1120 |
Prophylaxis - child |
47 |
45 |
$0.00 |
| D2950 |
|
15 |
15 |
$0.00 |
| D1999 |
|
150 |
136 |
$0.00 |