| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
32,359 |
20,860 |
$5.96M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,082 |
12,772 |
$721K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,066 |
4,317 |
$232K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,943 |
2,287 |
$91K |
| 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 |
2,106 |
1,915 |
$64K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
411 |
380 |
$49K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,843 |
3,541 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,013 |
2,801 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
204 |
188 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
187 |
175 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
133 |
132 |
$11K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,708 |
3,417 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,017 |
2,836 |
$3K |
| 59430 |
|
63 |
56 |
$3K |
| 86403 |
|
900 |
856 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
121 |
118 |
$2K |
| 0001A |
|
38 |
38 |
$1K |
| 90480 |
|
75 |
75 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
100 |
98 |
$1K |
| 81003 |
|
1,338 |
967 |
$1K |
| 80053 |
Comprehensive metabolic panel |
4,000 |
3,888 |
$844.94 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
83 |
81 |
$792.21 |
| D1110 |
Prophylaxis - adult |
29 |
29 |
$756.00 |
| 90686 |
|
1,685 |
1,573 |
$681.34 |
| 0031A |
|
30 |
29 |
$680.00 |
| 81000 |
|
493 |
298 |
$618.54 |
| 0011A |
|
46 |
44 |
$597.16 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
737 |
655 |
$569.49 |
| 97169 |
|
33 |
29 |
$480.00 |
| 81001 |
|
1,327 |
1,160 |
$427.72 |
| 0012A |
|
23 |
23 |
$425.85 |
| D0140 |
Limited oral evaluation - problem focused |
15 |
14 |
$290.25 |
| 80061 |
Lipid panel |
2,141 |
2,132 |
$266.90 |
| 86738 |
|
18 |
18 |
$244.64 |
| 92551 |
|
1,244 |
1,179 |
$195.79 |
| 90715 |
|
42 |
40 |
$190.40 |
| 76810 |
|
28 |
26 |
$168.72 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
43 |
41 |
$138.38 |
| 90461 |
|
319 |
290 |
$100.65 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,025 |
1,019 |
$77.80 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
47 |
39 |
$58.96 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
47 |
39 |
$58.96 |
| 84443 |
Thyroid stimulating hormone (TSH) |
424 |
420 |
$27.75 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
201 |
168 |
$20.94 |
| 86580 |
|
16 |
14 |
$12.92 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
28 |
28 |
$6.96 |
| 85018 |
|
12 |
12 |
$1.99 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
27 |
25 |
$0.00 |
| 91300 |
|
37 |
37 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
14 |
14 |
$0.00 |
| 90380 |
|
13 |
13 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| 91301 |
|
99 |
97 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
68 |
68 |
$0.00 |
| 91319 |
|
14 |
14 |
$0.00 |
| 91305 |
|
14 |
14 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
28 |
28 |
$0.00 |
| 90656 |
|
320 |
313 |
$0.00 |
| 91303 |
|
30 |
29 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
35 |
34 |
$0.00 |
| 90677 |
|
44 |
41 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
98 |
74 |
$0.00 |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
12 |
12 |
$0.00 |
| 90697 |
|
13 |
13 |
$0.00 |
| 99000 |
|
78 |
64 |
$0.00 |