| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
64,345 |
38,563 |
$9.99M |
| 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 |
8,990 |
7,156 |
$355K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,874 |
807 |
$53K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,205 |
20,464 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,011 |
13,856 |
$28K |
| 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 |
1,004 |
440 |
$21K |
| 90832 |
Psychotherapy, 30 minutes with patient |
6,614 |
3,707 |
$12K |
| G0008 |
Administration of influenza virus vaccine |
1,457 |
1,407 |
$8K |
| 80305 |
|
1,523 |
1,137 |
$7K |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,052 |
3,575 |
$7K |
| 99215 |
Prolong outpt/office vis |
607 |
521 |
$3K |
| 0012A |
|
85 |
84 |
$3K |
| 0011A |
|
84 |
83 |
$3K |
| 0004A |
|
85 |
74 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
580 |
539 |
$2K |
| 0001A |
|
57 |
56 |
$2K |
| 0064A |
|
79 |
71 |
$2K |
| D0274 |
Bitewings - four radiographic images |
660 |
612 |
$2K |
| 0031A |
|
51 |
49 |
$2K |
| 0072A |
|
46 |
46 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
764 |
709 |
$1K |
| 0002A |
|
35 |
34 |
$1K |
| 99173 |
|
222 |
209 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,833 |
1,657 |
$1K |
| 0071A |
|
25 |
25 |
$932.25 |
| D1110 |
Prophylaxis - adult |
713 |
685 |
$922.74 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
289 |
273 |
$881.52 |
| D0603 |
|
295 |
284 |
$846.82 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
648 |
310 |
$730.86 |
| 90686 |
|
634 |
617 |
$730.59 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
161 |
153 |
$661.90 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
186 |
184 |
$587.96 |
| D0220 |
Intraoral - periapical first radiographic image |
558 |
509 |
$572.30 |
| D0330 |
Panoramic radiographic image |
240 |
231 |
$483.54 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
261 |
254 |
$453.04 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
415 |
322 |
$440.76 |
| G0009 |
Administration of pneumococcal vaccine |
97 |
96 |
$440.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
174 |
163 |
$430.34 |
| 0240U |
|
321 |
309 |
$410.28 |
| 90674 |
|
112 |
109 |
$364.51 |
| 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 |
172 |
171 |
$361.06 |
| 99000 |
|
248 |
197 |
$343.18 |
| D1206 |
Topical application of fluoride varnish |
1,040 |
1,005 |
$313.54 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
200 |
195 |
$292.72 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
502 |
485 |
$280.89 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
27 |
12 |
$279.58 |
| 0124A |
|
19 |
18 |
$258.86 |
| 90791 |
Psychiatric diagnostic evaluation |
179 |
154 |
$183.17 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
197 |
188 |
$161.18 |
| 81002 |
|
417 |
392 |
$157.86 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
253 |
247 |
$157.86 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
214 |
199 |
$155.68 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
209 |
204 |
$124.56 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
313 |
297 |
$93.38 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
392 |
375 |
$39.40 |
| 90662 |
|
12 |
12 |
$19.01 |
| S9453 |
Smoking cessation classes, non-physician provider, per session |
15 |
15 |
$12.98 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$1.34 |
| D1120 |
Prophylaxis - child |
255 |
244 |
$0.00 |
| 91300 |
|
274 |
249 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
49 |
48 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
323 |
228 |
$0.00 |
| D0270 |
|
113 |
109 |
$0.00 |
| 90715 |
|
25 |
24 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
60 |
58 |
$0.00 |
| 71046 |
Radiologic examination, chest; 2 views |
44 |
41 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
197 |
68 |
$0.00 |
| 96152 |
|
73 |
43 |
$0.00 |
| 96160 |
|
150 |
135 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
20 |
20 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
57 |
56 |
$0.00 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
63 |
63 |
$0.00 |
| 96127 |
|
198 |
181 |
$0.00 |
| 91301 |
|
156 |
154 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
64 |
61 |
$0.00 |
| 91307 |
|
87 |
86 |
$0.00 |
| 91303 |
|
52 |
51 |
$0.00 |
| 91306 |
|
62 |
56 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
43 |
41 |
$0.00 |
| 90656 |
|
93 |
93 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
34 |
24 |
$0.00 |
| 87807 |
|
13 |
12 |
$0.00 |
| 90694 |
|
30 |
29 |
$0.00 |