| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
65,941 |
47,009 |
$4.16M |
| 99199 |
Unlisted special service, procedure or report |
259,279 |
99,721 |
$1.85M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
8,692 |
5,185 |
$223K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,523 |
2,322 |
$215K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,135 |
2,235 |
$194K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,921 |
1,521 |
$152K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
645 |
487 |
$51K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
564 |
458 |
$17K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
840 |
717 |
$10K |
| 83655 |
|
579 |
491 |
$7K |
| 90461 |
|
5,684 |
3,251 |
$6K |
| 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 |
648 |
403 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
379 |
347 |
$5K |
| 99051 |
|
645 |
406 |
$4K |
| 3078F |
|
19,762 |
15,411 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
329 |
241 |
$2K |
| 3008F |
|
27,033 |
21,081 |
$1K |
| 99381 |
|
26 |
14 |
$1K |
| D0145 |
Oral evaluation for a patient under three years of age |
32 |
29 |
$973.20 |
| 87420 |
|
68 |
61 |
$927.64 |
| 90686 |
|
2,201 |
1,695 |
$879.57 |
| 85018 |
|
802 |
625 |
$705.97 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
41 |
37 |
$633.42 |
| 0134A |
|
23 |
13 |
$585.00 |
| 96160 |
|
533 |
516 |
$455.60 |
| D1206 |
Topical application of fluoride varnish |
32 |
29 |
$430.11 |
| 91313 |
|
23 |
13 |
$340.37 |
| 81003 |
|
123 |
112 |
$276.10 |
| 99490 |
Ccm add 20min |
106 |
89 |
$269.62 |
| 90656 |
|
157 |
146 |
$197.71 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
55 |
50 |
$197.04 |
| 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 |
134 |
120 |
$106.92 |
| 81002 |
|
13 |
13 |
$34.59 |
| 99484 |
|
12 |
12 |
$11.60 |
| 3079F |
|
1,676 |
1,445 |
$2.97 |
| 3074F |
|
21,477 |
16,769 |
$0.03 |
| 3044F |
|
95 |
84 |
$0.00 |
| 90723 |
|
1,555 |
1,115 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
623 |
509 |
$0.00 |
| 3075F |
|
343 |
306 |
$0.00 |
| 90651 |
|
126 |
65 |
$0.00 |
| 90647 |
|
659 |
575 |
$0.00 |
| 90619 |
|
21 |
12 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |
| 99000 |
|
148 |
140 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 99441 |
|
13 |
13 |
$0.00 |
| 3080F |
|
36 |
27 |
$0.00 |
| 99177 |
|
183 |
144 |
$0.00 |
| 90670 |
|
2,497 |
1,723 |
$0.00 |
| 90633 |
|
441 |
353 |
$0.00 |
| G9920 |
Screening performed and negative |
473 |
419 |
$0.00 |
| 3077F |
|
172 |
145 |
$0.00 |
| 90681 |
|
290 |
182 |
$0.00 |
| 90710 |
|
459 |
324 |
$0.00 |
| 90685 |
|
134 |
130 |
$0.00 |
| 90700 |
|
18 |
15 |
$0.00 |
| 90621 |
|
18 |
12 |
$0.00 |
| 90671 |
|
29 |
27 |
$0.00 |