| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,722 |
4,196 |
$271K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,843 |
1,713 |
$146K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
188 |
172 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
118 |
115 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
43 |
$3K |
| 99215 |
Prolong outpt/office vis |
32 |
29 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
592 |
548 |
$3K |
| 90686 |
|
231 |
216 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
68 |
64 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90461 |
|
289 |
265 |
$736.58 |
| 90670 |
|
139 |
128 |
$692.52 |
| 3074F |
|
717 |
658 |
$600.00 |
| 3079F |
|
261 |
248 |
$475.00 |
| 90656 |
|
43 |
38 |
$454.28 |
| 36415 |
Collection of venous blood by venipuncture |
187 |
174 |
$430.92 |
| 3078F |
|
529 |
487 |
$350.00 |
| 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 |
33 |
30 |
$274.08 |
| 3075F |
|
81 |
79 |
$200.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
25 |
$161.91 |
| 90723 |
|
26 |
25 |
$56.30 |
| 3077F |
|
30 |
28 |
$50.00 |
| 90648 |
|
48 |
39 |
$38.84 |
| 3080F |
|
26 |
25 |
$25.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
13 |
$0.00 |
| 99000 |
|
12 |
12 |
$0.00 |