| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
79,316 |
67,220 |
$15.46M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
88,368 |
51,981 |
$313K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,417 |
2,554 |
$128K |
| J3490 |
Unclassified drugs |
628 |
540 |
$51K |
| 0011A |
|
574 |
571 |
$38K |
| 0001A |
|
450 |
450 |
$30K |
| 0012A |
|
354 |
354 |
$24K |
| 90715 |
|
406 |
369 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,464 |
4,993 |
$14K |
| 0002A |
|
173 |
173 |
$12K |
| 90651 |
|
168 |
160 |
$9K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,859 |
1,309 |
$8K |
| A4267 |
Contraceptive supply, condom, male, each |
785 |
772 |
$7K |
| 90670 |
|
68 |
68 |
$6K |
| 90732 |
|
60 |
57 |
$5K |
| 0064A |
|
43 |
43 |
$3K |
| 81025 |
|
2,006 |
1,975 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,599 |
6,057 |
$2K |
| 97804 |
|
58 |
57 |
$2K |
| 99000 |
|
4,988 |
4,811 |
$2K |
| 90688 |
|
176 |
175 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
145 |
97 |
$2K |
| 99201 |
|
193 |
121 |
$1K |
| G9919 |
Screening performed and positive and provision of recommendations |
2,239 |
2,233 |
$1K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
26 |
13 |
$1K |
| 92552 |
|
66 |
58 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
715 |
553 |
$1K |
| 0031A |
|
15 |
15 |
$1K |
| 90686 |
|
146 |
146 |
$959.48 |
| 0134A |
|
12 |
12 |
$804.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,966 |
5,877 |
$781.44 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
974 |
750 |
$654.21 |
| 90671 |
|
271 |
271 |
$520.88 |
| 99401 |
|
46 |
43 |
$457.68 |
| 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 |
18 |
14 |
$445.68 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,458 |
4,385 |
$406.47 |
| 81003 |
|
2,943 |
2,653 |
$339.78 |
| 90656 |
|
187 |
187 |
$333.62 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
462 |
431 |
$316.47 |
| 99386 |
|
58 |
40 |
$263.08 |
| G9920 |
Screening performed and negative |
294 |
294 |
$229.68 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,129 |
782 |
$209.89 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
35,096 |
31,585 |
$155.03 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
119 |
80 |
$144.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
144 |
144 |
$119.80 |
| 99385 |
|
307 |
182 |
$112.96 |
| 90633 |
|
136 |
135 |
$109.80 |
| 82962 |
|
4,132 |
3,897 |
$108.53 |
| 85018 |
|
2,241 |
2,204 |
$91.52 |
| G9012 |
Other specified case management service not elsewhere classified |
2,224 |
1,606 |
$60.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
2,363 |
2,231 |
$58.76 |
| 90723 |
|
103 |
103 |
$57.60 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
623 |
596 |
$54.62 |
| 99173 |
|
1,118 |
1,116 |
$43.98 |
| 83655 |
|
111 |
111 |
$42.08 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
26 |
26 |
$40.26 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
498 |
290 |
$37.39 |
| 90707 |
|
14 |
14 |
$10.00 |
| 90716 |
|
15 |
15 |
$10.00 |
| 80305 |
|
274 |
270 |
$9.98 |
| 90785 |
|
492 |
242 |
$3.84 |
| 86580 |
|
24 |
24 |
$3.36 |
| 3077F |
|
2,818 |
2,552 |
$0.00 |
| 96160 |
|
2,565 |
2,557 |
$0.00 |
| 3078F |
|
13,716 |
13,020 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,513 |
699 |
$0.00 |
| 3046F |
|
864 |
846 |
$0.00 |
| 90734 |
|
15 |
15 |
$0.00 |
| 3051F |
|
431 |
428 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
493 |
493 |
$0.00 |
| 90461 |
|
559 |
559 |
$0.00 |
| 82948 |
|
100 |
100 |
$0.00 |
| 99397 |
|
147 |
146 |
$0.00 |
| 3045F |
|
159 |
158 |
$0.00 |
| 90681 |
|
40 |
40 |
$0.00 |
| 99188 |
|
118 |
118 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
140 |
91 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
46 |
43 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
248 |
156 |
$0.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
25 |
21 |
$0.00 |
| 91313 |
|
14 |
14 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
170 |
98 |
$0.00 |
| 90710 |
|
42 |
42 |
$0.00 |
| G0469 |
Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new 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 mental health visit |
19 |
18 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
21 |
12 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 3080F |
|
1,481 |
1,354 |
$0.00 |
| 3079F |
|
5,849 |
5,653 |
$0.00 |
| 3044F |
|
1,313 |
1,308 |
$0.00 |
| 3074F |
|
14,888 |
14,150 |
$0.00 |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
3,785 |
2,992 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
20,442 |
18,757 |
$0.00 |
| 3052F |
|
330 |
327 |
$0.00 |
| 3075F |
|
3,133 |
3,068 |
$0.00 |
| G8433 |
Screening for depression not completed, documented patient or medical reason |
190 |
184 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
86 |
85 |
$0.00 |
| 90677 |
|
29 |
29 |
$0.00 |
| 90647 |
|
14 |
14 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
26 |
26 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
18 |
18 |
$0.00 |