| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
50,730 |
43,115 |
$2.87M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
53,903 |
30,660 |
$1.46M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
35,063 |
18,563 |
$928K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,829 |
2,974 |
$241K |
| 11721 |
|
5,540 |
1,690 |
$87K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
2,519 |
1,559 |
$81K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
1,452 |
845 |
$49K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
615 |
331 |
$31K |
| 11056 |
|
890 |
260 |
$20K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
865 |
620 |
$18K |
| 92552 |
|
1,048 |
673 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
393 |
211 |
$16K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
575 |
524 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
327 |
235 |
$10K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,350 |
639 |
$9K |
| 11750 |
|
114 |
27 |
$8K |
| A4217 |
Sterile water/saline, 500 ml |
1,938 |
890 |
$8K |
| 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 |
451 |
451 |
$4K |
| 90686 |
|
250 |
153 |
$3K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
622 |
256 |
$3K |
| 85018 |
|
2,216 |
1,308 |
$2K |
| 81002 |
|
2,603 |
1,573 |
$2K |
| 96127 |
|
574 |
295 |
$2K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
1,685 |
789 |
$2K |
| 99173 |
|
695 |
583 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
105 |
43 |
$1K |
| 90734 |
|
151 |
71 |
$1K |
| 80305 |
|
151 |
126 |
$1K |
| 90651 |
|
94 |
49 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
31 |
17 |
$897.28 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
143 |
78 |
$681.03 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
281 |
115 |
$662.56 |
| 90715 |
|
68 |
35 |
$591.50 |
| 90688 |
|
19 |
19 |
$423.70 |
| 90716 |
|
37 |
20 |
$368.73 |
| 90620 |
|
38 |
25 |
$351.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
16 |
$302.76 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
66 |
36 |
$246.63 |
| 90707 |
|
30 |
16 |
$202.50 |
| 90633 |
|
25 |
13 |
$162.00 |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
303 |
141 |
$114.88 |
| 99442 |
|
29 |
28 |
$92.03 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
15 |
$86.27 |
| 82962 |
|
23 |
12 |
$23.54 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
70 |
30 |
$22.88 |
| A4927 |
Gloves, non-sterile, per 100 |
15 |
12 |
$0.24 |
| 1159F |
|
6,779 |
6,027 |
$0.01 |
| 1160F |
|
6,791 |
6,038 |
$0.01 |
| 3008F |
|
8,217 |
7,359 |
$0.00 |
| 3080F |
|
660 |
399 |
$0.00 |
| 3074F |
|
11,557 |
6,868 |
$0.00 |
| 3079F |
|
2,920 |
1,780 |
$0.00 |
| 3075F |
|
1,439 |
921 |
$0.00 |
| 99443 |
|
73 |
66 |
$0.00 |
| 3078F |
|
10,673 |
6,441 |
$0.00 |
| 3077F |
|
1,279 |
786 |
$0.00 |
| 3725F |
|
90 |
90 |
$0.00 |