| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,565 |
8,584 |
$616K |
| 99215 |
Prolong outpt/office vis |
7,174 |
4,981 |
$450K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,168 |
3,701 |
$185K |
| 99199 |
Unlisted special service, procedure or report |
23,934 |
23,039 |
$97K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
794 |
515 |
$53K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
200 |
127 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,659 |
1,035 |
$14K |
| 99406 |
|
2,439 |
1,613 |
$13K |
| 99401 |
|
1,786 |
1,133 |
$13K |
| 81025 |
|
1,803 |
1,136 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
80 |
61 |
$7K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
751 |
589 |
$6K |
| 99205 |
Prolong outpt/office vis |
69 |
49 |
$6K |
| 99441 |
|
389 |
215 |
$6K |
| 81002 |
|
3,456 |
2,395 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
80 |
47 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
725 |
439 |
$5K |
| 82962 |
|
2,868 |
1,955 |
$3K |
| 90688 |
|
373 |
262 |
$2K |
| 90674 |
|
343 |
205 |
$2K |
| 96127 |
|
843 |
554 |
$2K |
| 96160 |
|
1,114 |
726 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
32 |
22 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
120 |
86 |
$1K |
| 90756 |
|
95 |
86 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
21 |
13 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
88 |
43 |
$1K |
| 99051 |
|
133 |
78 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
122 |
49 |
$1K |
| 99408 |
|
41 |
24 |
$805.64 |
| 93000 |
|
69 |
60 |
$654.59 |
| 99421 |
|
39 |
25 |
$604.85 |
| 90682 |
|
16 |
16 |
$454.44 |
| 90686 |
|
84 |
57 |
$452.94 |
| 99402 |
|
45 |
39 |
$236.28 |
| 80305 |
|
24 |
12 |
$95.27 |
| 83037 |
|
649 |
425 |
$79.88 |
| 90662 |
|
24 |
13 |
$47.58 |
| 99173 |
|
374 |
227 |
$46.81 |
| 92551 |
|
201 |
126 |
$33.08 |
| 1036F |
|
5,913 |
3,627 |
$1.25 |
| 3077F |
|
1,881 |
1,198 |
$0.00 |
| 3078F |
|
4,615 |
3,050 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
3,636 |
2,288 |
$0.00 |
| 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 |
363 |
160 |
$0.00 |
| 99499 |
|
43 |
26 |
$0.00 |
| 3079F |
|
2,324 |
1,597 |
$0.00 |
| 3080F |
|
1,652 |
1,124 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
2,789 |
1,784 |
$0.00 |
| 3008F |
|
5,981 |
3,849 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
1,308 |
885 |
$0.00 |
| 3044F |
|
353 |
233 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
204 |
134 |
$0.00 |
| 3074F |
|
5,538 |
3,680 |
$0.00 |
| 3075F |
|
1,332 |
930 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
400 |
265 |
$0.00 |
| 1034F |
|
2,238 |
1,374 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
16 |
12 |
$0.00 |
| 1111F |
|
59 |
43 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
31 |
25 |
$0.00 |