| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,376 |
6,874 |
$712K |
| 99199 |
Unlisted special service, procedure or report |
55,668 |
25,518 |
$293K |
| 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 |
2,799 |
2,343 |
$33K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
60 |
54 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
46 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
2,658 |
2,238 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
105 |
69 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
95 |
58 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
173 |
41 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
266 |
220 |
$3K |
| 87428 |
|
43 |
41 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
20 |
12 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
28 |
21 |
$809.62 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
16 |
$308.36 |
| 92551 |
|
374 |
305 |
$184.47 |
| 99173 |
|
411 |
331 |
$173.05 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
12 |
$121.72 |
| 90656 |
|
16 |
12 |
$40.08 |
| 90686 |
|
53 |
50 |
$38.38 |
| 81003 |
|
13 |
12 |
$30.16 |
| 96127 |
|
48 |
44 |
$4.25 |
| 3078F |
|
130 |
127 |
$0.08 |
| 3074F |
|
95 |
94 |
$0.08 |
| 3077F |
|
14 |
14 |
$0.01 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
32 |
28 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$0.00 |