| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
30,403 |
27,219 |
$2.09M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24,113 |
14,348 |
$533K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,253 |
7,820 |
$391K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12,082 |
7,415 |
$237K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,995 |
2,986 |
$158K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,519 |
2,666 |
$128K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,853 |
1,676 |
$89K |
| 99381 |
|
853 |
519 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
711 |
408 |
$24K |
| 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 |
1,844 |
1,643 |
$20K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,736 |
1,711 |
$16K |
| 92551 |
|
4,882 |
2,882 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,604 |
2,337 |
$13K |
| 99215 |
Prolong outpt/office vis |
254 |
159 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,008 |
658 |
$8K |
| 99442 |
|
659 |
353 |
$7K |
| 99441 |
|
1,183 |
647 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
573 |
304 |
$6K |
| 90686 |
|
2,479 |
1,510 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
224 |
148 |
$6K |
| 99173 |
|
5,797 |
3,432 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
3,877 |
2,477 |
$5K |
| 0012A |
|
115 |
112 |
$4K |
| 82962 |
|
3,616 |
2,330 |
$4K |
| 85018 |
|
3,483 |
2,119 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
167 |
81 |
$4K |
| 90674 |
|
583 |
323 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
229 |
201 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
65 |
42 |
$2K |
| 0011A |
|
67 |
57 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
49 |
26 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
35 |
16 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
105 |
66 |
$1K |
| 99443 |
|
86 |
48 |
$1K |
| 99383 |
|
22 |
12 |
$851.73 |
| 83655 |
|
917 |
563 |
$813.17 |
| 90651 |
|
730 |
450 |
$807.00 |
| 0064A |
|
27 |
17 |
$697.54 |
| 0013A |
|
17 |
14 |
$619.68 |
| 0124A |
|
23 |
13 |
$455.68 |
| 0072A |
|
12 |
12 |
$451.92 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
105 |
62 |
$440.92 |
| 90480 |
|
21 |
16 |
$389.94 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
59 |
44 |
$388.10 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
50 |
31 |
$362.24 |
| 90734 |
|
420 |
247 |
$347.64 |
| 81002 |
|
261 |
165 |
$283.21 |
| 90710 |
|
1,948 |
1,223 |
$264.31 |
| 90671 |
|
435 |
228 |
$246.20 |
| 90670 |
|
3,409 |
2,147 |
$241.38 |
| 90633 |
|
2,288 |
1,450 |
$144.00 |
| 81025 |
|
31 |
28 |
$95.29 |
| 90672 |
|
323 |
201 |
$57.27 |
| 90647 |
|
2,340 |
1,472 |
$53.95 |
| 90700 |
|
809 |
517 |
$53.38 |
| 90715 |
|
126 |
83 |
$30.96 |
| 3044F |
|
108 |
64 |
$20.25 |
| 3079F |
|
2,717 |
1,551 |
$2.75 |
| 3074F |
|
3,567 |
1,997 |
$2.70 |
| 3078F |
|
3,301 |
1,885 |
$2.46 |
| 3077F |
|
982 |
605 |
$1.73 |
| 91301 |
|
298 |
255 |
$1.58 |
| 3075F |
|
1,243 |
685 |
$1.53 |
| 3008F |
|
3,099 |
1,847 |
$0.57 |
| 3080F |
|
209 |
123 |
$0.43 |
| 91307 |
|
56 |
40 |
$0.42 |
| 91311 |
|
39 |
24 |
$0.23 |
| 91312 |
|
24 |
14 |
$0.13 |
| 90681 |
|
1,452 |
883 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
965 |
929 |
$0.00 |
| 90685 |
|
412 |
300 |
$0.00 |
| 90687 |
|
292 |
187 |
$0.00 |
| 91321 |
|
52 |
42 |
$0.00 |
| 90707 |
|
25 |
16 |
$0.00 |
| 90661 |
|
107 |
98 |
$0.00 |
| 90723 |
|
2,015 |
1,261 |
$0.00 |
| 90696 |
|
173 |
108 |
$0.00 |
| 90697 |
|
968 |
554 |
$0.00 |
| 90677 |
|
306 |
221 |
$0.00 |
| 90656 |
|
21 |
21 |
$0.00 |
| 90619 |
|
18 |
18 |
$0.00 |
| 90716 |
|
25 |
16 |
$0.00 |