| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
23,965 |
22,303 |
$5.34M |
| 0064A |
|
52 |
52 |
$960.00 |
| 0134A |
|
14 |
14 |
$520.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,659 |
5,403 |
$140.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
926 |
882 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
487 |
480 |
$0.00 |
| 81025 |
|
410 |
374 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
251 |
248 |
$0.00 |
| 90461 |
|
47 |
47 |
$0.00 |
| 99173 |
|
13 |
13 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |
| 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 |
69 |
68 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
290 |
283 |
$0.00 |
| 97802 |
|
111 |
97 |
$0.00 |
| 90656 |
|
13 |
13 |
$0.00 |
| 90686 |
|
121 |
121 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
30 |
$0.00 |
| 91301 |
|
46 |
46 |
$0.00 |
| 0012A |
|
13 |
13 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
18 |
$0.00 |