| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,186 |
3,406 |
$745K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,986 |
14,901 |
$188K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,725 |
2,472 |
$64K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,110 |
3,012 |
$37K |
| 90461 |
|
1,803 |
943 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
473 |
462 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
216 |
216 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
512 |
497 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
148 |
148 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
85 |
85 |
$3K |
| 90677 |
|
14 |
14 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
67 |
67 |
$2K |
| 90686 |
|
404 |
380 |
$2K |
| 99383 |
|
41 |
41 |
$672.80 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
25 |
25 |
$607.32 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$310.90 |
| 90630 |
|
15 |
15 |
$172.50 |
| 90658 |
|
28 |
28 |
$163.96 |
| 90656 |
|
37 |
37 |
$118.05 |
| 92551 |
|
28 |
28 |
$81.14 |
| 81025 |
|
13 |
13 |
$32.55 |
| 99173 |
|
46 |
46 |
$31.84 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
554 |
478 |
$19.89 |
| 90657 |
|
43 |
43 |
$9.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,626 |
1,396 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
57 |
$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 |
48 |
41 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
132 |
131 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
50 |
50 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
66 |
62 |
$0.00 |