| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
96,226 |
78,558 |
$10.02M |
| D1110 |
Prophylaxis - adult |
1,307 |
1,259 |
$61K |
| D0330 |
Panoramic radiographic image |
837 |
816 |
$33K |
| D0274 |
Bitewings - four radiographic images |
1,052 |
1,018 |
$25K |
| D0120 |
Periodic oral evaluation - established patient |
1,172 |
1,122 |
$22K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
338 |
323 |
$14K |
| D0140 |
Limited oral evaluation - problem focused |
164 |
163 |
$7K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
400 |
142 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61,988 |
50,533 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
215 |
212 |
$2K |
| D1120 |
Prophylaxis - child |
28 |
25 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
28 |
25 |
$613.10 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,736 |
7,245 |
$491.30 |
| D0191 |
|
278 |
272 |
$390.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
37 |
36 |
$372.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
62 |
26 |
$264.00 |
| 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 |
14,911 |
7,147 |
$79.86 |
| 90837 |
Psychotherapy, 53 minutes with patient |
601 |
348 |
$20.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,899 |
4,727 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
194 |
152 |
$0.00 |
| 0011A |
|
147 |
147 |
$0.00 |
| 90688 |
|
2,167 |
1,826 |
$0.00 |
| 83986 |
|
12 |
12 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
865 |
788 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
725 |
640 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
6,112 |
5,658 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
750 |
411 |
$0.00 |
| 96127 |
|
1,129 |
1,100 |
$0.00 |
| 90647 |
|
14 |
14 |
$0.00 |
| 91301 |
|
397 |
391 |
$0.00 |
| 93000 |
|
444 |
408 |
$0.00 |
| 90686 |
|
707 |
632 |
$0.00 |
| 92551 |
|
1,198 |
1,162 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
3,715 |
1,821 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
324 |
278 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
142 |
131 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
307 |
285 |
$0.00 |
| 0012A |
|
149 |
144 |
$0.00 |
| D5899 |
|
239 |
159 |
$0.00 |
| 90732 |
|
58 |
45 |
$0.00 |
| J1815 |
Injection, insulin, per 5 units |
17 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
19 |
12 |
$0.00 |
| 0064A |
|
85 |
84 |
$0.00 |
| 82962 |
|
4,390 |
3,513 |
$0.00 |
| 99000 |
|
380 |
363 |
$0.00 |
| 86580 |
|
35 |
34 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 96161 |
|
73 |
71 |
$0.00 |
| D9995 |
|
15 |
15 |
$0.00 |
| 99406 |
|
18 |
17 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
13 |
$0.00 |
| 91306 |
|
47 |
47 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
36 |
20 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90474 |
|
13 |
13 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
564 |
488 |
$0.00 |
| 81025 |
|
3,736 |
3,618 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
11,089 |
9,436 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,323 |
1,250 |
$0.00 |
| 90715 |
|
227 |
206 |
$0.00 |
| 90746 |
|
131 |
105 |
$0.00 |
| 99201 |
|
129 |
115 |
$0.00 |
| 11056 |
|
81 |
74 |
$0.00 |
| 87210 |
|
1,039 |
659 |
$0.00 |
| D2999 |
|
700 |
647 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,353 |
1,244 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
326 |
324 |
$0.00 |
| 81002 |
|
3,853 |
3,325 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
491 |
476 |
$0.00 |
| 99173 |
|
1,056 |
1,027 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
941 |
675 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
574 |
552 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
387 |
373 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
387 |
361 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
203 |
195 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
257 |
135 |
$0.00 |
| 11721 |
|
1,120 |
982 |
$0.00 |
| 90670 |
|
304 |
235 |
$0.00 |
| 86703 |
|
95 |
93 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
76 |
69 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
13 |
12 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
59 |
58 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
34 |
32 |
$0.00 |