| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
65,641 |
45,355 |
$11.29M |
| T1016 |
Case management, each 15 minutes |
1,293 |
900 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,834 |
15,289 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,718 |
8,913 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,617 |
2,256 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,348 |
1,099 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
109 |
79 |
$727.72 |
| 90686 |
|
1,959 |
1,614 |
$644.64 |
| 3008F |
|
11,099 |
8,377 |
$525.22 |
| 3044F |
|
1,339 |
1,175 |
$525.22 |
| H0031 |
Mental health assessment, by non-physician |
3,495 |
2,993 |
$465.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
54 |
44 |
$413.25 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
15,731 |
8,064 |
$291.00 |
| 3048F |
|
2,266 |
1,969 |
$262.61 |
| 3075F |
|
1,922 |
1,562 |
$262.61 |
| 3074F |
|
6,235 |
4,982 |
$262.61 |
| 3049F |
|
1,880 |
1,698 |
$262.61 |
| 3079F |
|
3,142 |
2,577 |
$262.61 |
| 3078F |
|
6,730 |
5,372 |
$262.61 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
2,689 |
1,592 |
$261.17 |
| H2014 |
Skills training and development, per 15 minutes |
1,749 |
1,087 |
$218.04 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
76 |
57 |
$147.70 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
480 |
414 |
$123.52 |
| 96150 |
|
207 |
122 |
$39.58 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
111 |
91 |
$35.98 |
| 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 |
987 |
850 |
$35.23 |
| 90715 |
|
430 |
365 |
$33.39 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
108 |
92 |
$24.58 |
| 90685 |
|
28 |
27 |
$22.71 |
| G0008 |
Administration of influenza virus vaccine |
225 |
201 |
$6.59 |
| 81002 |
|
151 |
122 |
$3.02 |
| 96127 |
|
26 |
25 |
$0.00 |
| 3060F |
|
488 |
394 |
$0.00 |
| 1126F |
|
178 |
171 |
$0.00 |
| 1170F |
|
286 |
264 |
$0.00 |
| H0038 |
Self-help/peer services, per 15 minutes |
415 |
304 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
453 |
437 |
$0.00 |
| 90656 |
|
136 |
133 |
$0.00 |
| 99443 |
|
103 |
99 |
$0.00 |
| 3052F |
|
140 |
130 |
$0.00 |
| 90688 |
|
43 |
43 |
$0.00 |
| 3014F |
|
360 |
322 |
$0.00 |
| 1125F |
|
39 |
35 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
370 |
318 |
$0.00 |
| 90677 |
|
14 |
13 |
$0.00 |
| 3080F |
|
371 |
287 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
731 |
471 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
177 |
146 |
$0.00 |
| 99000 |
|
34 |
34 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$0.00 |
| 99441 |
|
14 |
14 |
$0.00 |
| 0513F |
|
35 |
32 |
$0.00 |
| 1034F |
|
34 |
31 |
$0.00 |
| 90651 |
|
28 |
27 |
$0.00 |
| 1157F |
|
121 |
108 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
27 |
12 |
$0.00 |
| 93000 |
|
24 |
24 |
$0.00 |
| 1000F |
|
49 |
44 |
$0.00 |
| 1036F |
|
21 |
21 |
$0.00 |
| 3017F |
|
13 |
13 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
441 |
428 |
$0.00 |
| 3050F |
|
765 |
671 |
$0.00 |
| 3077F |
|
1,843 |
1,480 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
53 |
53 |
$0.00 |
| 3046F |
|
484 |
427 |
$0.00 |
| 3051F |
|
413 |
364 |
$0.00 |
| 99442 |
|
257 |
241 |
$0.00 |
| 90662 |
|
220 |
206 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,241 |
779 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
19 |
14 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
73 |
57 |
$0.00 |
| 90461 |
|
109 |
108 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
165 |
142 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
52 |
48 |
$0.00 |
| 3725F |
|
188 |
172 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
36 |
29 |
$0.00 |
| 0004A |
|
41 |
38 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
33 |
27 |
$0.00 |
| 1158F |
|
223 |
205 |
$0.00 |
| 90670 |
|
80 |
47 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
36 |
26 |
$0.00 |
| H2027 |
Psychoeducational service, per 15 minutes |
93 |
41 |
$0.00 |
| 81025 |
|
37 |
36 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$0.00 |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$0.00 |