| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
115,778 |
78,688 |
$14.13M |
| 99199 |
Unlisted special service, procedure or report |
181,108 |
96,461 |
$1.01M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,077 |
2,978 |
$321K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,382 |
2,631 |
$294K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,490 |
2,358 |
$274K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17,369 |
12,728 |
$228K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,383 |
1,698 |
$207K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,018 |
6,510 |
$191K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
7,590 |
4,834 |
$54K |
| 99401 |
|
2,035 |
1,303 |
$49K |
| 92551 |
|
14,033 |
10,574 |
$31K |
| 96127 |
|
4,883 |
3,445 |
$14K |
| 99173 |
|
15,731 |
11,906 |
$12K |
| 97802 |
|
396 |
262 |
$7K |
| 96160 |
|
3,949 |
2,465 |
$6K |
| 0071A |
|
120 |
96 |
$5K |
| D0145 |
Oral evaluation for a patient under three years of age |
137 |
103 |
$4K |
| 90670 |
|
1,865 |
1,257 |
$4K |
| 0012A |
|
82 |
78 |
$4K |
| 90734 |
|
184 |
108 |
$4K |
| 90656 |
|
948 |
852 |
$4K |
| 99384 |
|
46 |
32 |
$3K |
| 0072A |
|
91 |
59 |
$3K |
| 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 |
128 |
105 |
$3K |
| 90480 |
|
54 |
44 |
$2K |
| 0074A |
|
49 |
21 |
$2K |
| D1206 |
Topical application of fluoride varnish |
117 |
91 |
$2K |
| 0011A |
|
41 |
38 |
$1K |
| 96161 |
|
722 |
474 |
$948.88 |
| 0112A |
|
20 |
13 |
$910.00 |
| 90716 |
|
392 |
271 |
$745.00 |
| 98967 |
|
18 |
15 |
$428.76 |
| 97803 |
|
18 |
12 |
$393.22 |
| 90707 |
|
340 |
238 |
$352.86 |
| 90715 |
|
107 |
75 |
$245.72 |
| 90680 |
|
212 |
148 |
$184.88 |
| 90723 |
|
871 |
614 |
$0.00 |
| 3008F |
|
4,711 |
3,482 |
$0.00 |
| 90647 |
|
916 |
645 |
$0.00 |
| 90651 |
|
153 |
103 |
$0.00 |
| 91307 |
|
432 |
280 |
$0.00 |
| 3351F |
|
149 |
72 |
$0.00 |
| 90677 |
|
236 |
205 |
$0.00 |
| 90620 |
|
35 |
26 |
$0.00 |
| 91301 |
|
173 |
158 |
$0.00 |
| 90686 |
|
44 |
39 |
$0.00 |
| 90619 |
|
83 |
66 |
$0.00 |
| 3074F |
|
35 |
24 |
$0.00 |
| 90645 |
|
15 |
12 |
$0.00 |
| 90633 |
|
306 |
229 |
$0.00 |
| 3078F |
|
108 |
82 |
$0.00 |
| 90700 |
|
39 |
30 |
$0.00 |
| 91300 |
|
25 |
13 |
$0.00 |
| 91311 |
|
22 |
15 |
$0.00 |