| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
38,809 |
31,750 |
$10.44M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,858 |
7,002 |
$3K |
| 0012A |
|
131 |
131 |
$1K |
| 0011A |
|
191 |
187 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,351 |
2,221 |
$802.53 |
| 0001A |
|
287 |
287 |
$800.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,228 |
4,021 |
$762.12 |
| 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 |
1,212 |
1,073 |
$708.11 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
821 |
733 |
$691.80 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,216 |
7,337 |
$583.69 |
| 90670 |
|
940 |
906 |
$488.81 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
513 |
414 |
$420.00 |
| 0002A |
|
256 |
256 |
$400.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
983 |
880 |
$344.00 |
| 96156 |
|
489 |
480 |
$274.00 |
| 90723 |
|
499 |
482 |
$160.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
397 |
377 |
$150.00 |
| 99177 |
|
846 |
823 |
$128.00 |
| 92551 |
|
374 |
308 |
$108.00 |
| 90647 |
|
619 |
602 |
$62.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
142 |
121 |
$58.35 |
| 90474 |
|
165 |
158 |
$54.00 |
| 81003 |
|
503 |
470 |
$24.00 |
| 99051 |
|
1,357 |
1,271 |
$20.98 |
| 99173 |
|
487 |
404 |
$2.56 |
| 90686 |
|
1,282 |
1,226 |
$0.74 |
| 90734 |
|
134 |
119 |
$0.37 |
| 1159F |
|
3,357 |
3,123 |
$0.04 |
| 1220F |
|
1,790 |
1,730 |
$0.02 |
| 1036F |
|
2,550 |
2,341 |
$0.01 |
| 81025 |
|
114 |
102 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
97 |
87 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
869 |
591 |
$0.00 |
| 1003F |
|
359 |
339 |
$0.00 |
| 1158F |
|
1,291 |
1,224 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,499 |
1,373 |
$0.00 |
| 96152 |
|
195 |
177 |
$0.00 |
| 91300 |
|
507 |
461 |
$0.00 |
| D0190 |
|
604 |
603 |
$0.00 |
| 90713 |
|
41 |
41 |
$0.00 |
| 90473 |
|
17 |
15 |
$0.00 |
| 90681 |
|
295 |
288 |
$0.00 |
| 90707 |
|
163 |
153 |
$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 |
59 |
59 |
$0.00 |
| 81002 |
|
104 |
89 |
$0.00 |
| 90633 |
|
233 |
213 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
13 |
$0.00 |
| 90700 |
|
236 |
223 |
$0.00 |
| 90715 |
|
158 |
146 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
75 |
67 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
164 |
142 |
$0.00 |
| 90461 |
|
16 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
106 |
103 |
$0.00 |
| 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 |
34 |
33 |
$0.00 |
| 90685 |
|
58 |
53 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |
| 90750 |
|
32 |
32 |
$0.00 |
| 90662 |
|
15 |
15 |
$0.00 |
| 1160F |
|
47 |
45 |
$0.00 |
| 96127 |
|
47 |
46 |
$0.00 |
| 97802 |
|
46 |
45 |
$0.00 |
| 90651 |
|
158 |
132 |
$0.00 |
| 90688 |
|
572 |
540 |
$0.00 |
| 1125F |
|
1,037 |
988 |
$0.00 |
| 1126F |
|
405 |
359 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
419 |
418 |
$0.00 |
| 99381 |
|
30 |
26 |
$0.00 |
| 90716 |
|
179 |
167 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
101 |
92 |
$0.00 |
| 90696 |
|
24 |
24 |
$0.00 |
| 96150 |
|
67 |
60 |
$0.00 |
| 90620 |
|
96 |
80 |
$0.00 |
| 91301 |
|
270 |
266 |
$0.00 |
| 96154 |
|
109 |
100 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
34 |
33 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
26 |
26 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
19 |
19 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
35 |
30 |
$0.00 |