| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
38,998 |
35,965 |
$8.71M |
| 0134A |
|
84 |
84 |
$3K |
| 0002A |
|
86 |
81 |
$2K |
| 0064A |
|
85 |
80 |
$2K |
| 0001A |
|
93 |
84 |
$2K |
| 0124A |
|
25 |
25 |
$920.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,247 |
9,724 |
$105.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,035 |
2,901 |
$78.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,648 |
1,621 |
$36.00 |
| 92551 |
|
302 |
299 |
$16.00 |
| 90686 |
|
549 |
548 |
$14.64 |
| 99173 |
|
501 |
489 |
$12.00 |
| 81025 |
|
2,521 |
2,323 |
$8.00 |
| 90461 |
|
367 |
366 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
49 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
109 |
104 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
38 |
38 |
$0.00 |
| 90648 |
|
25 |
25 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
53 |
53 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
33 |
33 |
$0.00 |
| 87210 |
|
68 |
68 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 3008F |
|
286 |
263 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
606 |
595 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,605 |
1,588 |
$0.00 |
| 97802 |
|
451 |
421 |
$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 |
219 |
194 |
$0.00 |
| 90656 |
|
94 |
94 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| D1330 |
|
12 |
12 |
$0.00 |
| 91306 |
|
28 |
28 |
$0.00 |
| 82962 |
|
28 |
27 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 91301 |
|
19 |
16 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |