| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
17,262 |
14,286 |
$4.56M |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
9,699 |
6,903 |
$532K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,187 |
2,078 |
$528K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,771 |
1,670 |
$430K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,675 |
1,614 |
$424K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,274 |
1,244 |
$342K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
5,910 |
3,992 |
$236K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,361 |
1,883 |
$126K |
| 99307 |
|
1,257 |
842 |
$36K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
557 |
506 |
$15K |
| 99381 |
|
58 |
55 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
162 |
140 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,344 |
5,041 |
$12K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,102 |
3,162 |
$8K |
| 90686 |
|
1,460 |
1,359 |
$6K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
226 |
147 |
$5K |
| 99305 |
|
37 |
37 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,960 |
1,489 |
$3K |
| 99306 |
Prolong nursin fac eval 15m |
25 |
25 |
$3K |
| 90651 |
|
437 |
423 |
$2K |
| 96160 |
|
1,595 |
1,548 |
$2K |
| 90633 |
|
440 |
422 |
$557.30 |
| CP008 |
|
19 |
13 |
$220.00 |
| 90474 |
|
714 |
684 |
$134.94 |
| 3074F |
|
1,031 |
1,009 |
$0.00 |
| 90680 |
|
760 |
730 |
$0.00 |
| 3008F |
|
1,891 |
1,809 |
$0.00 |
| 92551 |
|
41 |
41 |
$0.00 |
| 1036F |
|
745 |
725 |
$0.00 |
| 1126F |
|
867 |
834 |
$0.00 |
| 90677 |
|
280 |
260 |
$0.00 |
| 90723 |
|
356 |
347 |
$0.00 |
| 90716 |
|
54 |
51 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
65 |
65 |
$0.00 |
| 90696 |
|
56 |
56 |
$0.00 |
| 90656 |
|
118 |
109 |
$0.00 |
| 90697 |
|
14 |
14 |
$0.00 |
| 90698 |
|
14 |
14 |
$0.00 |
| 90619 |
|
16 |
16 |
$0.00 |
| 90670 |
|
1,141 |
1,096 |
$0.00 |
| 1159F |
|
1,783 |
1,704 |
$0.00 |
| 1160F |
|
1,812 |
1,733 |
$0.00 |
| 3078F |
|
957 |
938 |
$0.00 |
| 90734 |
|
224 |
223 |
$0.00 |
| 90710 |
|
58 |
58 |
$0.00 |
| 90715 |
|
44 |
44 |
$0.00 |
| 90648 |
|
774 |
749 |
$0.00 |
| 90672 |
|
99 |
96 |
$0.00 |
| 90649 |
|
43 |
43 |
$0.00 |
| 90707 |
|
54 |
51 |
$0.00 |
| 90700 |
|
28 |
26 |
$0.00 |
| 90473 |
|
83 |
83 |
$0.00 |