| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
30,167 |
25,966 |
$3.51M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
954 |
878 |
$114K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
856 |
847 |
$104K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
587 |
574 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
354 |
352 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,509 |
2,318 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,810 |
6,827 |
$22K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
686 |
665 |
$9K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
149 |
149 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,270 |
1,261 |
$2K |
| 87428 |
|
348 |
339 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,637 |
1,573 |
$916.14 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
656 |
638 |
$556.64 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
17 |
17 |
$345.12 |
| 99307 |
|
13 |
13 |
$271.78 |
| 99304 |
|
13 |
13 |
$253.37 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,903 |
1,156 |
$245.33 |
| 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 |
14 |
12 |
$172.28 |
| 90686 |
|
278 |
274 |
$36.89 |
| 81002 |
|
302 |
227 |
$11.55 |
| 90671 |
|
43 |
43 |
$0.14 |
| 96127 |
|
406 |
403 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
166 |
158 |
$0.00 |
| 90723 |
|
53 |
53 |
$0.00 |
| 90474 |
|
237 |
236 |
$0.00 |
| 90697 |
|
27 |
27 |
$0.00 |
| 90698 |
|
14 |
13 |
$0.00 |
| 90680 |
|
334 |
328 |
$0.00 |
| 90677 |
|
55 |
54 |
$0.00 |
| 90733 |
|
56 |
56 |
$0.00 |
| 87430 |
|
59 |
57 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
13 |
12 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16 |
15 |
$0.00 |
| 90715 |
|
42 |
42 |
$0.00 |
| 90633 |
|
141 |
141 |
$0.00 |
| 90648 |
|
151 |
151 |
$0.00 |
| 90461 |
|
691 |
667 |
$0.00 |
| 90670 |
|
547 |
539 |
$0.00 |
| 81003 |
|
311 |
222 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 90649 |
|
65 |
65 |
$0.00 |
| 90710 |
|
59 |
59 |
$0.00 |