| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
91,379 |
90,545 |
$4.59M |
| T1015 |
Clinic visit/encounter, all-inclusive |
63,435 |
52,529 |
$3.65M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,385 |
28,276 |
$212K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,256 |
6,313 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
660 |
501 |
$8K |
| 87206 |
|
991 |
888 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
291 |
284 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
154 |
146 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
168 |
163 |
$2K |
| 90734 |
|
119 |
112 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
42 |
39 |
$801.18 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
96 |
94 |
$590.36 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,241 |
1,191 |
$250.00 |
| 90756 |
|
13 |
13 |
$165.36 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
510 |
470 |
$32.08 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
516 |
434 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
452 |
423 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
47 |
44 |
$0.00 |
| 87807 |
|
16 |
16 |
$0.00 |
| 90619 |
|
32 |
31 |
$0.00 |
| 90674 |
|
53 |
51 |
$0.00 |
| 0011A |
|
14 |
14 |
$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 |
18,509 |
18,217 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,384 |
2,255 |
$0.00 |
| 81002 |
|
167 |
154 |
$0.00 |
| J2010 |
Injection, lincomycin hcl, up to 300 mg |
82 |
78 |
$0.00 |
| 90649 |
|
12 |
12 |
$0.00 |
| 90715 |
|
18 |
17 |
$0.00 |