| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,598 |
5,078 |
$384K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,459 |
3,516 |
$115K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
916 |
589 |
$32K |
| 90686 |
|
199 |
107 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
52 |
40 |
$818.74 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
59 |
41 |
$634.19 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
104 |
49 |
$448.98 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
26 |
$285.23 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
37 |
30 |
$190.34 |
| 36415 |
Collection of venous blood by venipuncture |
90 |
70 |
$105.39 |
| 96127 |
|
16 |
12 |
$31.76 |
| 3074F |
|
1,211 |
1,010 |
$0.07 |
| 3079F |
|
106 |
91 |
$0.03 |
| 3078F |
|
974 |
828 |
$0.01 |
| 4004F |
|
28 |
25 |
$0.00 |
| 3008F |
|
343 |
240 |
$0.00 |
| 1036F |
|
520 |
421 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
63 |
48 |
$0.00 |