| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,222 |
4,945 |
$922K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,648 |
4,009 |
$96K |
| 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 |
1,469 |
1,387 |
$50K |
| D0999 |
Unspecified diagnostic procedure, by report |
115 |
109 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
189 |
171 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
88 |
78 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54 |
52 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
547 |
478 |
$1K |
| 0001A |
|
14 |
14 |
$550.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
564 |
521 |
$369.49 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
121 |
117 |
$52.24 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
28 |
27 |
$29.58 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
933 |
830 |
$26.40 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
546 |
475 |
$13.21 |
| 90461 |
|
119 |
111 |
$3.72 |
| 3008F |
|
1,129 |
1,053 |
$0.00 |
| 90686 |
|
187 |
174 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
63 |
$0.00 |
| D0603 |
|
52 |
52 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$0.00 |
| 90656 |
|
19 |
19 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$0.00 |
| 92551 |
|
46 |
46 |
$0.00 |
| 99173 |
|
174 |
166 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
13 |
13 |
$0.00 |
| 91300 |
|
52 |
44 |
$0.00 |