| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
50,439 |
43,265 |
$12.16M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52,709 |
31,687 |
$156K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,037 |
802 |
$28K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,504 |
1,938 |
$19K |
| 0012A |
|
192 |
192 |
$13K |
| 0011A |
|
164 |
164 |
$11K |
| J3490 |
Unclassified drugs |
103 |
95 |
$9K |
| 90837 |
Psychotherapy, 53 minutes with patient |
705 |
345 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,360 |
5,482 |
$5K |
| 0001A |
|
57 |
55 |
$4K |
| 0064A |
|
49 |
49 |
$3K |
| 90677 |
|
214 |
213 |
$3K |
| 90715 |
|
106 |
83 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
530 |
349 |
$2K |
| 0134A |
|
25 |
25 |
$2K |
| 81025 |
|
1,589 |
1,545 |
$2K |
| 99000 |
|
3,141 |
3,046 |
$2K |
| 0002A |
|
15 |
15 |
$1K |
| A4267 |
Contraceptive supply, condom, male, each |
127 |
122 |
$811.75 |
| 0013A |
|
13 |
13 |
$806.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
1,348 |
1,347 |
$776.62 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,004 |
625 |
$657.20 |
| 99385 |
|
619 |
397 |
$568.22 |
| 97804 |
|
12 |
12 |
$495.72 |
| 90688 |
|
32 |
32 |
$325.56 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
131 |
101 |
$311.16 |
| 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 |
12 |
12 |
$297.12 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
198 |
193 |
$280.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
20,794 |
19,310 |
$274.91 |
| 99386 |
|
364 |
248 |
$263.08 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,176 |
3,141 |
$261.05 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
294 |
170 |
$203.70 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,266 |
2,228 |
$181.01 |
| 90656 |
|
83 |
83 |
$158.41 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
116 |
67 |
$149.19 |
| G9920 |
Screening performed and negative |
134 |
134 |
$144.13 |
| 85018 |
|
1,479 |
1,459 |
$119.89 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
86 |
86 |
$119.20 |
| 81002 |
|
1,338 |
1,229 |
$95.21 |
| 81003 |
|
800 |
720 |
$88.79 |
| 90723 |
|
41 |
41 |
$63.90 |
| 82962 |
|
2,980 |
2,860 |
$61.11 |
| 90832 |
Psychotherapy, 30 minutes with patient |
274 |
195 |
$52.34 |
| 90648 |
|
44 |
44 |
$43.63 |
| 99188 |
|
44 |
44 |
$35.64 |
| 90686 |
|
18 |
18 |
$26.54 |
| G9012 |
Other specified case management service not elsewhere classified |
1,675 |
1,476 |
$20.00 |
| 99173 |
|
1,104 |
1,100 |
$15.46 |
| 80305 |
|
14 |
14 |
$11.85 |
| 90633 |
|
27 |
27 |
$9.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
100 |
99 |
$4.46 |
| 82948 |
|
229 |
212 |
$2.68 |
| 96160 |
|
1,416 |
1,414 |
$2.54 |
| 3077F |
|
1,783 |
1,663 |
$0.00 |
| 3051F |
|
184 |
184 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
187 |
183 |
$0.00 |
| 3078F |
|
7,272 |
6,913 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
19 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
37 |
$0.00 |
| 99397 |
|
28 |
27 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
159 |
155 |
$0.00 |
| 3046F |
|
27 |
27 |
$0.00 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
16 |
14 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
18 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
16 |
$0.00 |
| 90734 |
|
15 |
15 |
$0.00 |
| 3079F |
|
4,968 |
4,793 |
$0.00 |
| 3044F |
|
832 |
831 |
$0.00 |
| 3074F |
|
9,268 |
8,758 |
$0.00 |
| G8433 |
Screening for depression not completed, documented patient or medical reason |
1,365 |
1,301 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
14,650 |
13,684 |
$0.00 |
| 3075F |
|
2,324 |
2,275 |
$0.00 |
| G9008 |
Coordinated care fee, physician coordinated care oversight services |
2,689 |
2,145 |
$0.00 |
| 3080F |
|
1,091 |
1,028 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
279 |
196 |
$0.00 |
| 2000F |
|
65 |
61 |
$0.00 |
| 3008F |
|
88 |
80 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
15 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
23 |
23 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
29 |
29 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
35 |
26 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
56 |
56 |
$0.00 |
| 3052F |
|
15 |
15 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
14 |
14 |
$0.00 |