| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
20,291 |
15,147 |
$4.22M |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,544 |
1,528 |
$8K |
| 0002A |
|
179 |
179 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
215 |
207 |
$5K |
| D1110 |
Prophylaxis - adult |
107 |
107 |
$5K |
| 0001A |
|
165 |
164 |
$4K |
| 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 |
27 |
25 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
137 |
137 |
$1K |
| 99460 |
|
13 |
12 |
$956.56 |
| 99462 |
|
19 |
12 |
$696.78 |
| 90473 |
|
61 |
61 |
$597.99 |
| 0012A |
|
14 |
14 |
$490.00 |
| 0004A |
|
15 |
15 |
$390.00 |
| 0071A |
|
13 |
13 |
$390.00 |
| 90686 |
|
513 |
512 |
$375.46 |
| 87428 |
|
19 |
18 |
$165.00 |
| 36415 |
Collection of venous blood by venipuncture |
363 |
350 |
$140.95 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$118.08 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$36.80 |
| D0120 |
Periodic oral evaluation - established patient |
55 |
55 |
$32.22 |
| 90672 |
|
105 |
105 |
$20.00 |
| 90674 |
|
44 |
44 |
$10.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,327 |
6,658 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
210 |
190 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,096 |
1,044 |
$0.00 |
| 3079F |
|
27 |
26 |
$0.00 |
| 3074F |
|
548 |
514 |
$0.00 |
| 2001F |
|
563 |
508 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$0.00 |
| 90651 |
|
25 |
25 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
310 |
196 |
$0.00 |
| 86803 |
|
15 |
15 |
$0.00 |
| 90660 |
|
13 |
13 |
$0.00 |
| 91301 |
|
14 |
14 |
$0.00 |
| 91305 |
|
15 |
13 |
$0.00 |
| 91307 |
|
30 |
26 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
204 |
185 |
$0.00 |
| 91300 |
|
404 |
374 |
$0.00 |
| 3078F |
|
482 |
450 |
$0.00 |
| 1159F |
|
749 |
694 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
114 |
110 |
$0.00 |
| 86703 |
|
89 |
88 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
14 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
35 |
26 |
$0.00 |
| 80305 |
|
14 |
12 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
49 |
37 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$0.00 |