| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
34,162 |
24,172 |
$17.02M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,257 |
7,230 |
$329K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,675 |
3,418 |
$68K |
| 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 |
531 |
425 |
$37K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
618 |
554 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,599 |
2,372 |
$8K |
| T1016 |
Case management, each 15 minutes |
96 |
76 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
72 |
72 |
$42.19 |
| 36415 |
Collection of venous blood by venipuncture |
1,903 |
1,857 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,859 |
1,840 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
144 |
144 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
1,826 |
1,805 |
$0.00 |
| 99443 |
|
2,220 |
2,049 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
367 |
255 |
$0.00 |
| 36416 |
|
1,161 |
1,120 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
203 |
187 |
$0.00 |
| 90686 |
|
793 |
788 |
$0.00 |
| 99000 |
|
3,872 |
3,487 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,563 |
2,236 |
$0.00 |
| D1330 |
|
1,144 |
1,114 |
$0.00 |
| 96127 |
|
28 |
27 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,649 |
815 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
457 |
358 |
$0.00 |
| L3050 |
Foot, arch support, removable, premolded, metatarsal, each |
78 |
78 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
895 |
848 |
$0.00 |
| 90680 |
|
51 |
51 |
$0.00 |
| 99441 |
|
485 |
467 |
$0.00 |
| 90474 |
|
25 |
25 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
612 |
610 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
52 |
52 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
57 |
55 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
101 |
100 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
169 |
150 |
$0.00 |
| 90651 |
|
26 |
26 |
$0.00 |
| 90723 |
|
80 |
80 |
$0.00 |
| D1351 |
Sealant - per tooth |
979 |
192 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
67 |
67 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
133 |
132 |
$0.00 |
| 91301 |
|
120 |
119 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$0.00 |
| 0011A |
|
13 |
13 |
$0.00 |
| 90647 |
|
98 |
96 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
21 |
21 |
$0.00 |
| 82962 |
|
32 |
31 |
$0.00 |
| 0012A |
|
28 |
28 |
$0.00 |
| 98967 |
|
16 |
14 |
$0.00 |
| D1310 |
|
12 |
12 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
61 |
44 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
41 |
41 |
$0.00 |
| D0330 |
Panoramic radiographic image |
484 |
482 |
$0.00 |
| 92015 |
Determination of refractive state |
177 |
177 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
516 |
413 |
$0.00 |
| D1354 |
|
614 |
172 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,668 |
1,571 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
150 |
150 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
246 |
169 |
$0.00 |
| 99071 |
|
66 |
64 |
$0.00 |
| D1120 |
Prophylaxis - child |
108 |
108 |
$0.00 |
| D0190 |
|
3,215 |
2,711 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,139 |
846 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
242 |
215 |
$0.00 |
| 90715 |
|
27 |
27 |
$0.00 |
| D0270 |
|
16 |
16 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
160 |
156 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
137 |
134 |
$0.00 |
| 99442 |
|
1,395 |
1,337 |
$0.00 |
| D0180 |
|
241 |
237 |
$0.00 |
| D1110 |
Prophylaxis - adult |
214 |
214 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
554 |
554 |
$0.00 |
| 90670 |
|
237 |
237 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
50 |
50 |
$0.00 |
| 99201 |
|
500 |
498 |
$0.00 |
| D0191 |
|
736 |
736 |
$0.00 |
| 2028F |
|
199 |
179 |
$0.00 |
| D4910 |
|
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$0.00 |
| 11721 |
|
267 |
262 |
$0.00 |
| 99001 |
|
37 |
37 |
$0.00 |
| 82948 |
|
23 |
23 |
$0.00 |
| 90736 |
|
13 |
13 |
$0.00 |
| 90750 |
|
12 |
12 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
12 |
12 |
$0.00 |
| 11056 |
|
100 |
98 |
$0.00 |
| D4341 |
|
65 |
45 |
$0.00 |
| 90461 |
|
33 |
33 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |
| 98968 |
|
29 |
29 |
$0.00 |
| 80061 |
Lipid panel |
120 |
120 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
15 |
15 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$0.00 |