| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,307 |
3,897 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,009 |
949 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
917 |
884 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
165 |
165 |
$600.89 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
495 |
495 |
$544.02 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$390.09 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
948 |
947 |
$350.36 |
| 96127 |
|
1,119 |
1,114 |
$163.12 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
106 |
106 |
$156.27 |
| 94760 |
|
3,823 |
3,363 |
$150.99 |
| 99401 |
|
1,813 |
1,603 |
$116.73 |
| 99000 |
|
109 |
108 |
$62.38 |
| 81000 |
|
125 |
125 |
$52.43 |
| 92552 |
|
14 |
14 |
$49.56 |
| 3074F |
|
3,545 |
3,182 |
$43.36 |
| 3008F |
|
5,815 |
5,063 |
$30.27 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
36 |
36 |
$28.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
16 |
16 |
$22.50 |
| 3078F |
|
3,536 |
3,174 |
$18.64 |
| 36415 |
Collection of venous blood by venipuncture |
347 |
342 |
$16.14 |
| 1160F |
|
2,941 |
2,526 |
$0.01 |
| 4245F |
|
25 |
25 |
$0.00 |
| 1000F |
|
1,013 |
1,012 |
$0.00 |
| 3075F |
|
717 |
691 |
$0.00 |
| 3079F |
|
1,139 |
1,079 |
$0.00 |
| 3080F |
|
695 |
640 |
$0.00 |
| 1126F |
|
517 |
514 |
$0.00 |
| 1125F |
|
983 |
941 |
$0.00 |
| 1036F |
|
902 |
901 |
$0.00 |
| 1101F |
|
424 |
421 |
$0.00 |
| 1111F |
|
26 |
26 |
$0.00 |
| 1157F |
|
109 |
109 |
$0.00 |
| 3044F |
|
61 |
61 |
$0.00 |
| 99172 |
|
78 |
78 |
$0.00 |
| 1170F |
|
25 |
25 |
$0.00 |
| 4450F |
|
78 |
78 |
$0.00 |
| 3048F |
|
25 |
25 |
$0.00 |
| 90657 |
|
17 |
17 |
$0.00 |
| 97802 |
|
12 |
12 |
$0.00 |
| 3077F |
|
1,118 |
1,017 |
$0.00 |
| 1124F |
|
369 |
369 |
$0.00 |
| 1159F |
|
2,883 |
2,484 |
$0.00 |
| 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 |
26 |
26 |
$0.00 |
| 4035F |
|
17 |
17 |
$0.00 |
| 99483 |
Prolong outpt/office vis |
26 |
26 |
$0.00 |