| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
27,312 |
21,173 |
$6.68M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,299 |
5,530 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,133 |
8,729 |
$7K |
| 11721 |
|
469 |
408 |
$361.50 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,794 |
1,565 |
$157.44 |
| 0003A |
|
14 |
14 |
$120.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
202 |
192 |
$94.80 |
| 3074F |
|
45 |
42 |
$80.00 |
| 3079F |
|
31 |
30 |
$80.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,033 |
1,004 |
$59.74 |
| 3078F |
|
29 |
27 |
$40.00 |
| 3044F |
|
15 |
13 |
$20.00 |
| 0001A |
|
118 |
118 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
317 |
289 |
$0.00 |
| 90686 |
|
1,163 |
1,137 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
913 |
881 |
$0.00 |
| 90656 |
|
69 |
69 |
$0.00 |
| 91301 |
|
33 |
33 |
$0.00 |
| 90677 |
|
14 |
13 |
$0.00 |
| 90480 |
|
100 |
93 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
69 |
66 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
27 |
27 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
28 |
28 |
$0.00 |
| 90651 |
|
44 |
43 |
$0.00 |
| 91307 |
|
14 |
14 |
$0.00 |
| 0011A |
|
16 |
16 |
$0.00 |
| 91305 |
|
18 |
18 |
$0.00 |
| 0012A |
|
16 |
16 |
$0.00 |
| 90734 |
|
91 |
88 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
94 |
93 |
$0.00 |
| 90461 |
|
170 |
166 |
$0.00 |
| 91300 |
|
318 |
304 |
$0.00 |
| 91312 |
|
33 |
33 |
$0.00 |
| 0002A |
|
101 |
101 |
$0.00 |
| 0054A |
|
13 |
13 |
$0.00 |
| 0124A |
|
40 |
39 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
321 |
290 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |
| 90715 |
|
58 |
53 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
34 |
$0.00 |
| 91320 |
|
64 |
59 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$0.00 |