| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,771 |
8,646 |
$1.17M |
| H2020 |
Therapeutic behavioral services, per diem |
1,393 |
835 |
$118K |
| D0999 |
Unspecified diagnostic procedure, by report |
39 |
32 |
$5K |
| 99050 |
|
206 |
125 |
$2K |
| 99051 |
|
69 |
59 |
$774.64 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
36 |
$325.78 |
| 0071A |
|
59 |
19 |
$141.24 |
| 0001A |
|
103 |
27 |
$124.16 |
| 0012A |
|
328 |
96 |
$74.16 |
| 0072A |
|
34 |
16 |
$63.00 |
| 0011A |
|
346 |
123 |
$52.90 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,092 |
763 |
$30.42 |
| 3008F |
|
1,816 |
1,557 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
450 |
258 |
$0.00 |
| 1000F |
|
518 |
429 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,666 |
3,871 |
$0.00 |
| 3351F |
|
2,242 |
1,762 |
$0.00 |
| 1170F |
|
266 |
231 |
$0.00 |
| 1126F |
|
636 |
546 |
$0.00 |
| 1157F |
|
293 |
244 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
388 |
307 |
$0.00 |
| 3074F |
|
576 |
509 |
$0.00 |
| 80358 |
|
16 |
14 |
$0.00 |
| 1220F |
|
742 |
488 |
$0.00 |
| 90686 |
|
54 |
49 |
$0.00 |
| 3079F |
|
183 |
154 |
$0.00 |
| 91307 |
|
124 |
53 |
$0.00 |
| 92551 |
|
175 |
150 |
$0.00 |
| 2001F |
|
98 |
92 |
$0.00 |
| 4060F |
|
358 |
238 |
$0.00 |
| 91301 |
|
800 |
278 |
$0.00 |
| 85018 |
|
102 |
93 |
$0.00 |
| 90688 |
|
59 |
52 |
$0.00 |
| 3044F |
|
129 |
105 |
$0.00 |
| 4010F |
|
80 |
69 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
260 |
178 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
35 |
26 |
$0.00 |
| 81005 |
|
57 |
39 |
$0.00 |
| 1125F |
|
129 |
107 |
$0.00 |
| 3075F |
|
105 |
87 |
$0.00 |
| 90674 |
|
15 |
14 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
81 |
56 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
34 |
25 |
$0.00 |
| 99386 |
|
16 |
15 |
$0.00 |
| 3017F |
|
27 |
27 |
$0.00 |
| 1036F |
|
27 |
27 |
$0.00 |
| 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 |
12 |
12 |
$0.00 |
| 1123F |
|
33 |
29 |
$0.00 |
| 3072F |
|
16 |
12 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
19 |
15 |
$0.00 |
| 3014F |
|
29 |
29 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
909 |
518 |
$0.00 |
| 1160F |
|
1,778 |
1,473 |
$0.00 |
| 4004F |
|
32 |
22 |
$0.00 |
| 1158F |
|
390 |
344 |
$0.00 |
| 90749 |
|
263 |
229 |
$0.00 |
| 99173 |
|
187 |
162 |
$0.00 |
| 1159F |
|
1,790 |
1,497 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
127 |
118 |
$0.00 |
| 85014 |
|
101 |
92 |
$0.00 |
| 90658 |
|
72 |
65 |
$0.00 |
| 3078F |
|
442 |
384 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
126 |
88 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
46 |
36 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
140 |
121 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
15 |
$0.00 |
| 11721 |
|
14 |
14 |
$0.00 |
| 3046F |
|
19 |
15 |
$0.00 |
| 91300 |
|
138 |
45 |
$0.00 |
| 96160 |
|
65 |
39 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
22 |
15 |
$0.00 |
| 0521F |
|
27 |
27 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
30 |
30 |
$0.00 |
| 84439 |
|
19 |
15 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
78 |
53 |
$0.00 |
| 30000 |
|
14 |
13 |
$0.00 |