| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,635 |
9,034 |
$1.65M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,653 |
6,247 |
$1.08M |
| T1015 |
Clinic visit/encounter, all-inclusive |
3,765 |
3,568 |
$490K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
545 |
527 |
$99K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
658 |
616 |
$53K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
405 |
400 |
$41K |
| 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 |
1,184 |
1,036 |
$34K |
| 90686 |
|
1,973 |
1,926 |
$28K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
123 |
121 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,201 |
4,060 |
$14K |
| 87428 |
|
451 |
437 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,176 |
1,141 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
55 |
55 |
$7K |
| 90648 |
|
522 |
515 |
$7K |
| 90670 |
|
400 |
392 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
53 |
51 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
172 |
167 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$4K |
| 90723 |
|
284 |
278 |
$4K |
| 99177 |
|
56 |
51 |
$3K |
| 99383 |
|
17 |
17 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
16 |
12 |
$3K |
| 90677 |
|
125 |
121 |
$3K |
| 99385 |
|
12 |
12 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$2K |
| 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 |
28 |
28 |
$2K |
| 90656 |
|
194 |
193 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
145 |
102 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
13 |
$2K |
| 36416 |
|
1,109 |
1,032 |
$2K |
| 90715 |
|
63 |
55 |
$1K |
| D1206 |
Topical application of fluoride varnish |
71 |
59 |
$1K |
| 90681 |
|
85 |
81 |
$1K |
| 90633 |
|
75 |
71 |
$959.03 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,229 |
1,186 |
$790.97 |
| 93000 |
|
13 |
13 |
$602.64 |
| 90680 |
|
37 |
37 |
$597.59 |
| 81002 |
|
173 |
164 |
$452.54 |
| 99188 |
|
52 |
50 |
$449.73 |
| 90707 |
|
26 |
26 |
$443.94 |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$429.00 |
| 85018 |
|
227 |
222 |
$423.91 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
24 |
$380.19 |
| 83655 |
|
24 |
24 |
$297.42 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$228.00 |
| 90688 |
|
17 |
17 |
$143.49 |
| 85014 |
|
16 |
16 |
$14.22 |
| 3044F |
|
78 |
77 |
$0.14 |
| 90474 |
|
56 |
52 |
$0.00 |
| 0013A |
|
86 |
86 |
$0.00 |
| 0003A |
|
12 |
12 |
$0.00 |