| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
66,345 |
54,032 |
$4.71M |
| 00003 |
Internal/system code - not a standard HCPCS code |
13,075 |
10,456 |
$2.17M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
86,768 |
54,590 |
$18K |
| 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 |
1,026 |
822 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,997 |
5,179 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,892 |
1,523 |
$502.52 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,518 |
977 |
$329.00 |
| 90677 |
|
484 |
340 |
$293.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,070 |
2,998 |
$249.83 |
| 59425 |
|
47 |
24 |
$241.92 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,399 |
3,631 |
$184.62 |
| 92551 |
|
4,644 |
3,485 |
$175.43 |
| 85018 |
|
8,563 |
6,411 |
$160.78 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
123 |
92 |
$62.01 |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
217 |
152 |
$61.90 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,431 |
1,149 |
$57.20 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
565 |
549 |
$41.16 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
529 |
518 |
$40.08 |
| 99173 |
|
6,744 |
4,820 |
$24.20 |
| 90686 |
|
3,974 |
3,232 |
$23.38 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,063 |
1,050 |
$23.22 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
16 |
13 |
$19.89 |
| 90723 |
|
1,231 |
975 |
$9.00 |
| 90648 |
|
1,534 |
1,152 |
$9.00 |
| 83655 |
|
83 |
50 |
$8.50 |
| 99000 |
|
837 |
680 |
$7.26 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,257 |
917 |
$7.16 |
| 81005 |
|
965 |
713 |
$7.10 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
23 |
15 |
$6.11 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
34 |
20 |
$5.16 |
| 90680 |
|
618 |
516 |
$0.00 |
| 3008F |
|
1,475 |
985 |
$0.00 |
| 2001F |
|
1,473 |
983 |
$0.00 |
| 90651 |
|
598 |
427 |
$0.00 |
| 87428 |
|
72 |
49 |
$0.00 |
| 1111F |
|
1,350 |
929 |
$0.00 |
| 90656 |
|
415 |
309 |
$0.00 |
| 1036F |
|
1,076 |
718 |
$0.00 |
| J3490 |
Unclassified drugs |
28 |
28 |
$0.00 |
| 90647 |
|
424 |
418 |
$0.00 |
| 90716 |
|
68 |
60 |
$0.00 |
| 99383 |
|
12 |
12 |
$0.00 |
| 90620 |
|
144 |
101 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
287 |
170 |
$0.00 |
| 3079F |
|
66 |
46 |
$0.00 |
| Z1034 |
|
417 |
260 |
$0.00 |
| 3074F |
|
345 |
210 |
$0.00 |
| 0011A |
|
12 |
12 |
$0.00 |
| 82962 |
|
21 |
17 |
$0.00 |
| 99381 |
|
41 |
38 |
$0.00 |
| 90696 |
|
60 |
38 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 3048F |
|
37 |
32 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
17 |
$0.00 |
| 3075F |
|
21 |
15 |
$0.00 |
| 99385 |
|
25 |
17 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,645 |
1,691 |
$0.00 |
| 90670 |
|
1,399 |
1,178 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
92 |
62 |
$0.00 |
| 90715 |
|
193 |
170 |
$0.00 |
| 81025 |
|
225 |
196 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
22 |
22 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
84 |
84 |
$0.00 |
| 3078F |
|
281 |
173 |
$0.00 |
| 90734 |
|
464 |
331 |
$0.00 |
| 81003 |
|
123 |
81 |
$0.00 |
| 90633 |
|
972 |
783 |
$0.00 |
| 90707 |
|
44 |
44 |
$0.00 |
| 3077F |
|
50 |
31 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
19 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
57 |
57 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
72 |
71 |
$0.00 |
| 90710 |
|
127 |
93 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
239 |
141 |
$0.00 |
| 90461 |
|
34 |
34 |
$0.00 |
| 90700 |
|
39 |
39 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
18 |
13 |
$0.00 |