| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,094 |
4,309 |
$1.06M |
| D0999 |
Unspecified diagnostic procedure, by report |
1,805 |
1,559 |
$344K |
| 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 |
872 |
719 |
$20K |
| S9999 |
Sales tax |
891 |
594 |
$11K |
| 90832 |
Psychotherapy, 30 minutes with patient |
296 |
242 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,376 |
2,055 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,305 |
1,853 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
25 |
14 |
$2K |
| 81002 |
|
1,367 |
966 |
$1K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
148 |
106 |
$675.60 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
24 |
24 |
$625.07 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
599 |
550 |
$477.30 |
| 81003 |
|
288 |
274 |
$361.73 |
| 36416 |
|
243 |
216 |
$177.89 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
161 |
161 |
$177.89 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
210 |
207 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
396 |
278 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
116 |
94 |
$0.00 |
| 90656 |
|
108 |
108 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
108 |
107 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
14 |
$0.00 |
| 99173 |
|
64 |
64 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
46 |
46 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
209 |
184 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$0.00 |
| 87400 |
|
13 |
13 |
$0.00 |
| D1110 |
Prophylaxis - adult |
24 |
24 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 94150 |
|
13 |
13 |
$0.00 |