| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,171 |
8,263 |
$630K |
| 99199 |
Unlisted special service, procedure or report |
32,381 |
20,463 |
$170K |
| 87428 |
|
243 |
183 |
$9K |
| 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 |
217 |
181 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
327 |
129 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
127 |
89 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
84 |
55 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
304 |
248 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
27 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
53 |
45 |
$664.76 |
| 92551 |
|
411 |
298 |
$463.58 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
14 |
$411.30 |
| 99173 |
|
425 |
313 |
$168.23 |
| 90686 |
|
14 |
13 |
$114.27 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$91.65 |
| 81003 |
|
28 |
25 |
$81.74 |
| 99442 |
|
13 |
13 |
$0.00 |
| 3725F |
|
17 |
12 |
$0.00 |