| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,329 |
23,455 |
$4.05M |
| H0046 |
Mental health services, not otherwise specified |
15,337 |
5,617 |
$1.22M |
| H0034 |
Medication training and support, per 15 minutes |
3,589 |
1,365 |
$313K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,517 |
5,101 |
$2K |
| 3078F |
|
2,478 |
2,335 |
$669.94 |
| 3074F |
|
2,860 |
2,691 |
$584.93 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
832 |
794 |
$569.63 |
| D0120 |
Periodic oral evaluation - established patient |
413 |
407 |
$256.41 |
| 3079F |
|
1,010 |
973 |
$230.00 |
| 3075F |
|
360 |
349 |
$120.00 |
| D1110 |
Prophylaxis - adult |
296 |
289 |
$90.72 |
| D0274 |
Bitewings - four radiographic images |
191 |
185 |
$83.58 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
13 |
12 |
$77.48 |
| 3077F |
|
81 |
80 |
$60.00 |
| D1206 |
Topical application of fluoride varnish |
126 |
126 |
$40.46 |
| 3725F |
|
243 |
229 |
$10.00 |
| 2000F |
|
5,112 |
4,773 |
$0.00 |
| 2001F |
|
5,150 |
4,817 |
$0.00 |
| 3008F |
|
5,688 |
5,273 |
$0.00 |
| 99000 |
|
78 |
76 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
716 |
706 |
$0.00 |
| 3035F |
|
541 |
506 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
134 |
134 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
97 |
52 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
20 |
12 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
13 |
12 |
$0.00 |
| 90686 |
|
69 |
69 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 3028F |
|
2,976 |
2,760 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
168 |
160 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
87 |
81 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
24 |
24 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
73 |
71 |
$0.00 |
| D9110 |
|
33 |
31 |
$0.00 |
| 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 |
43 |
42 |
$0.00 |
| D1120 |
Prophylaxis - child |
14 |
14 |
$0.00 |