| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,308 |
6,428 |
$668K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,817 |
8,757 |
$389K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,602 |
3,587 |
$153K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
305 |
245 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
562 |
412 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
827 |
664 |
$10K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
53 |
44 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
252 |
202 |
$3K |
| 90670 |
|
171 |
149 |
$2K |
| 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 |
172 |
125 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
56 |
42 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
13 |
$894.27 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
58 |
20 |
$595.70 |
| 90698 |
|
63 |
57 |
$556.65 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$519.84 |
| 90744 |
|
31 |
27 |
$150.00 |
| 90686 |
|
12 |
12 |
$101.06 |
| 36415 |
Collection of venous blood by venipuncture |
52 |
42 |
$97.63 |
| 90688 |
|
13 |
13 |
$79.91 |
| 90680 |
|
13 |
13 |
$70.00 |
| 3074F |
|
41 |
38 |
$0.00 |
| 3079F |
|
20 |
19 |
$0.00 |
| 90674 |
|
64 |
63 |
$0.00 |
| 90633 |
|
15 |
14 |
$0.00 |
| 90710 |
|
17 |
15 |
$0.00 |