| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
35,270 |
29,524 |
$4.83M |
| 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 |
11,524 |
10,237 |
$519K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,382 |
19,202 |
$476K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,800 |
15,179 |
$281K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
6,663 |
2,687 |
$140K |
| D1206 |
Topical application of fluoride varnish |
2,755 |
2,611 |
$123K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,710 |
3,280 |
$123K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,791 |
941 |
$111K |
| D0220 |
Intraoral - periapical first radiographic image |
1,922 |
1,836 |
$104K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
3,203 |
2,857 |
$92K |
| D1120 |
Prophylaxis - child |
1,660 |
1,589 |
$76K |
| D0140 |
Limited oral evaluation - problem focused |
2,210 |
2,092 |
$75K |
| D1330 |
|
1,028 |
1,015 |
$67K |
| 20610 |
|
2,449 |
2,177 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
384 |
369 |
$47K |
| D0120 |
Periodic oral evaluation - established patient |
2,104 |
1,993 |
$43K |
| D0274 |
Bitewings - four radiographic images |
1,056 |
996 |
$42K |
| D1110 |
Prophylaxis - adult |
1,654 |
1,551 |
$39K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
898 |
856 |
$38K |
| D7140 |
Extraction, erupted tooth or exposed root |
752 |
472 |
$30K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
1,003 |
917 |
$30K |
| 99215 |
Prolong outpt/office vis |
583 |
461 |
$25K |
| D0230 |
Intraoral - periapical each additional radiographic image |
552 |
361 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
344 |
343 |
$22K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
297 |
261 |
$18K |
| D0272 |
Bitewings - two radiographic images |
349 |
349 |
$16K |
| D1351 |
Sealant - per tooth |
628 |
121 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
242 |
236 |
$11K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
375 |
312 |
$10K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
310 |
307 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,455 |
2,369 |
$8K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
223 |
174 |
$6K |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
1,825 |
1,748 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
306 |
301 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
78 |
78 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
165 |
161 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
675 |
672 |
$5K |
| 88312 |
|
451 |
436 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$4K |
| 99222 |
Initial hospital care, per day, moderate complexity |
94 |
90 |
$4K |
| 99223 |
Prolong inpt eval add15 m |
53 |
53 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
134 |
115 |
$3K |
| 90756 |
|
638 |
621 |
$2K |
| G0127 |
Trimming of dystrophic nails, any number |
482 |
457 |
$2K |
| 99307 |
|
1,926 |
1,648 |
$2K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
35 |
25 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,555 |
1,474 |
$2K |
| 88307 |
|
51 |
49 |
$2K |
| 82962 |
|
1,196 |
1,138 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
26 |
$1K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
154 |
141 |
$1K |
| 94760 |
|
3,581 |
3,096 |
$1K |
| 99000 |
|
1,089 |
986 |
$1K |
| 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 |
265 |
263 |
$734.42 |
| D0603 |
|
255 |
252 |
$654.48 |
| 99442 |
|
70 |
66 |
$634.01 |
| 99217 |
|
25 |
24 |
$566.13 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
333 |
303 |
$524.34 |
| 99231 |
Subsequent hospital care, per day, straightforward or low complexity |
59 |
14 |
$518.02 |
| G0008 |
Administration of influenza virus vaccine |
636 |
618 |
$499.28 |
| 88304 |
|
71 |
71 |
$402.74 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
67 |
65 |
$371.50 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
107 |
103 |
$343.19 |
| 81002 |
|
441 |
414 |
$314.33 |
| 90474 |
|
76 |
76 |
$211.85 |
| 11055 |
|
16 |
13 |
$180.62 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
105 |
104 |
$160.63 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
372 |
361 |
$153.80 |
| 90715 |
|
126 |
116 |
$135.02 |
| 99441 |
|
52 |
43 |
$96.06 |
| 11720 |
|
14 |
14 |
$83.96 |
| 88108 |
|
14 |
12 |
$62.15 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
12 |
12 |
$28.65 |
| 90694 |
|
218 |
203 |
$22.16 |
| G0009 |
Administration of pneumococcal vaccine |
12 |
12 |
$21.23 |
| 99406 |
|
13 |
12 |
$1.71 |
| 36415 |
Collection of venous blood by venipuncture |
703 |
639 |
$1.00 |
| 90653 |
|
84 |
82 |
$0.00 |
| 96160 |
|
108 |
106 |
$0.00 |
| 91322 |
|
39 |
38 |
$0.00 |
| D0270 |
|
76 |
74 |
$0.00 |
| 90662 |
|
39 |
38 |
$0.00 |
| 0124A |
|
26 |
25 |
$0.00 |
| 91312 |
|
26 |
25 |
$0.00 |
| D0601 |
|
48 |
48 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
14 |
$0.00 |
| 90686 |
|
143 |
142 |
$0.00 |
| 90480 |
|
39 |
38 |
$0.00 |
| 90677 |
|
27 |
27 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
54 |
51 |
$0.00 |
| 90656 |
|
122 |
120 |
$0.00 |
| 85018 |
|
13 |
13 |
$0.00 |