| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
27,709 |
21,390 |
$2.70M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,533 |
1,459 |
$154K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,390 |
1,378 |
$145K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
671 |
670 |
$69K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
259 |
259 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
143 |
134 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,886 |
1,393 |
$2K |
| 99381 |
|
27 |
27 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
13 |
12 |
$1K |
| 90461 |
|
5,052 |
1,537 |
$327.49 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38 |
37 |
$117.07 |
| 90674 |
|
138 |
138 |
$107.84 |
| 81003 |
|
5,419 |
3,454 |
$9.65 |
| 81002 |
|
3,166 |
1,909 |
$5.84 |
| 90680 |
|
89 |
84 |
$0.00 |
| 90723 |
|
134 |
131 |
$0.00 |
| 90716 |
|
75 |
75 |
$0.00 |
| 99441 |
|
14 |
14 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |
| 90686 |
|
76 |
75 |
$0.00 |
| 90698 |
|
27 |
27 |
$0.00 |
| 90633 |
|
91 |
91 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
240 |
240 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |
| 90707 |
|
74 |
74 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,513 |
1,464 |
$0.00 |
| 90648 |
|
232 |
227 |
$0.00 |
| 90670 |
|
489 |
480 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 90685 |
|
117 |
116 |
$0.00 |
| 81025 |
|
91 |
87 |
$0.00 |