| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,269 |
14,934 |
$3.09M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,211 |
6,383 |
$1.12M |
| A0425 |
Ground mileage, per statute mile |
2,654 |
869 |
$219K |
| T2003 |
Non-emergency transportation; encounter/trip |
3,625 |
1,156 |
$185K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
986 |
866 |
$179K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
906 |
863 |
$175K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
719 |
701 |
$142K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
778 |
723 |
$131K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
440 |
435 |
$91K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
196 |
108 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,192 |
1,032 |
$13K |
| A0130 |
Non-emergency transportation: wheelchair van |
112 |
38 |
$12K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
799 |
775 |
$10K |
| A0100 |
Non-emergency transportation; taxi |
451 |
130 |
$10K |
| 90837 |
Psychotherapy, 53 minutes with patient |
29 |
25 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
122 |
59 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
156 |
154 |
$5K |
| 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 |
4,464 |
3,414 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
40 |
40 |
$3K |
| 99173 |
|
230 |
225 |
$2K |
| 90670 |
|
289 |
256 |
$833.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
65 |
63 |
$705.05 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
77 |
76 |
$417.48 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
13 |
12 |
$300.30 |
| 87905 |
|
14 |
13 |
$245.13 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,643 |
2,536 |
$201.38 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
12 |
12 |
$166.70 |
| 90651 |
|
94 |
91 |
$166.70 |
| 87807 |
|
16 |
16 |
$160.46 |
| 36415 |
Collection of venous blood by venipuncture |
2,393 |
2,150 |
$137.42 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13 |
12 |
$132.91 |
| 90715 |
|
137 |
130 |
$84.28 |
| 98940 |
|
646 |
473 |
$62.34 |
| 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 |
261 |
216 |
$61.25 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,504 |
1,445 |
$54.67 |
| 81003 |
|
165 |
145 |
$46.60 |
| 90686 |
|
531 |
506 |
$38.81 |
| 81002 |
|
96 |
75 |
$23.86 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
88 |
83 |
$22.20 |
| 90656 |
|
48 |
48 |
$19.77 |
| 81025 |
|
30 |
27 |
$13.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
58 |
53 |
$0.45 |
| 3078F |
|
540 |
444 |
$0.00 |
| 11721 |
|
40 |
39 |
$0.00 |
| 90734 |
|
87 |
83 |
$0.00 |
| 90633 |
|
122 |
112 |
$0.00 |
| 90710 |
|
45 |
45 |
$0.00 |
| 11719 |
|
14 |
14 |
$0.00 |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
56 |
31 |
$0.00 |
| 90648 |
|
16 |
13 |
$0.00 |
| 90723 |
|
145 |
137 |
$0.00 |
| 3079F |
|
303 |
264 |
$0.00 |
| 90680 |
|
97 |
88 |
$0.00 |
| 3075F |
|
253 |
217 |
$0.00 |
| 90696 |
|
15 |
15 |
$0.00 |
| 90677 |
|
110 |
108 |
$0.00 |
| 90647 |
|
141 |
140 |
$0.00 |
| 3074F |
|
129 |
110 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
12 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |