| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
135,370 |
65,576 |
$769K |
| T1015 |
Clinic visit/encounter, all-inclusive |
4,762 |
3,384 |
$556K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
69 |
49 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
458 |
308 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
304 |
208 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
20 |
12 |
$2K |
| 0001A |
|
35 |
18 |
$1K |
| 92587 |
|
76 |
50 |
$1K |
| 99383 |
|
15 |
12 |
$884.52 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
104 |
75 |
$786.75 |
| 0002A |
|
25 |
12 |
$780.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
35 |
29 |
$638.91 |
| 0012A |
|
13 |
13 |
$585.00 |
| 96127 |
|
195 |
134 |
$538.24 |
| 92551 |
|
328 |
260 |
$504.39 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
23 |
12 |
$464.85 |
| 99401 |
|
39 |
27 |
$334.76 |
| 99173 |
|
452 |
341 |
$275.51 |
| 0011A |
|
21 |
13 |
$267.76 |
| 90661 |
|
14 |
14 |
$163.25 |
| 90686 |
|
170 |
130 |
$38.35 |
| 85018 |
|
15 |
12 |
$31.19 |
| 96160 |
|
19 |
14 |
$29.95 |
| 91300 |
|
133 |
72 |
$0.00 |
| 90461 |
|
72 |
51 |
$0.00 |
| 91301 |
|
95 |
66 |
$0.00 |
| 90656 |
|
14 |
13 |
$0.00 |