| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
28,205 |
24,325 |
$3.63M |
| 99199 |
Unlisted special service, procedure or report |
122,898 |
54,656 |
$925K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,683 |
5,037 |
$501K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,217 |
4,610 |
$453K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,522 |
2,992 |
$332K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
2,749 |
2,280 |
$332K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,514 |
8,396 |
$238K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14,507 |
12,719 |
$179K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,537 |
1,337 |
$153K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,390 |
992 |
$71K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,657 |
3,259 |
$50K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
7,382 |
6,496 |
$47K |
| 90474 |
|
3,003 |
2,673 |
$37K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,134 |
1,931 |
$30K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
141 |
137 |
$19K |
| 99381 |
|
195 |
169 |
$13K |
| D0145 |
Oral evaluation for a patient under three years of age |
303 |
298 |
$10K |
| 92551 |
|
7,643 |
6,492 |
$9K |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
300 |
226 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,611 |
2,410 |
$6K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
146 |
144 |
$4K |
| D1206 |
Topical application of fluoride varnish |
300 |
296 |
$4K |
| 99173 |
|
9,141 |
7,846 |
$4K |
| 96127 |
|
3,379 |
2,839 |
$3K |
| 90677 |
|
490 |
471 |
$2K |
| 96161 |
|
2,623 |
2,267 |
$2K |
| 86703 |
|
313 |
299 |
$1K |
| 0001A |
|
16 |
16 |
$940.00 |
| 0071A |
|
27 |
15 |
$849.71 |
| 83655 |
|
1,226 |
1,146 |
$827.54 |
| 90686 |
|
3,643 |
3,169 |
$634.07 |
| 81003 |
|
285 |
278 |
$627.14 |
| 90791 |
Psychiatric diagnostic evaluation |
39 |
17 |
$564.24 |
| 85018 |
|
402 |
328 |
$471.54 |
| 87807 |
|
101 |
100 |
$282.48 |
| 90832 |
Psychotherapy, 30 minutes with patient |
88 |
59 |
$156.72 |
| 96160 |
|
68 |
66 |
$153.34 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
27 |
27 |
$124.72 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
27 |
27 |
$124.72 |
| 90656 |
|
214 |
211 |
$39.10 |
| 90647 |
|
3,759 |
3,406 |
$11.00 |
| 90670 |
|
4,482 |
4,006 |
$11.00 |
| 3074F |
|
2,943 |
2,738 |
$0.03 |
| 3078F |
|
2,820 |
2,621 |
$0.03 |
| 90723 |
|
3,775 |
3,392 |
$0.00 |
| 90716 |
|
262 |
256 |
$0.00 |
| 90619 |
|
124 |
94 |
$0.00 |
| 90680 |
|
3,054 |
2,717 |
$0.00 |
| 3008F |
|
2,976 |
2,784 |
$0.00 |
| 90696 |
|
140 |
100 |
$0.00 |
| 94760 |
|
14 |
13 |
$0.00 |
| 91307 |
|
116 |
77 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
146 |
127 |
$0.00 |
| 90651 |
|
36 |
25 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$0.00 |
| 1000F |
|
94 |
92 |
$0.00 |
| 90620 |
|
33 |
33 |
$0.00 |
| 99420 |
|
223 |
221 |
$0.00 |
| 90633 |
|
1,819 |
1,624 |
$0.00 |
| 90707 |
|
230 |
229 |
$0.00 |
| 90685 |
|
243 |
236 |
$0.00 |
| 90715 |
|
187 |
137 |
$0.00 |
| 90734 |
|
446 |
321 |
$0.00 |
| 90380 |
|
16 |
16 |
$0.00 |
| 90649 |
|
363 |
301 |
$0.00 |
| 90700 |
|
84 |
81 |
$0.00 |
| 91300 |
|
80 |
64 |
$0.00 |
| 90710 |
|
86 |
46 |
$0.00 |