| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
24,214 |
15,813 |
$980K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
33,812 |
21,852 |
$575K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
327 |
324 |
$8K |
| 36410 |
|
1,233 |
1,195 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$2K |
| 85018 |
|
786 |
773 |
$2K |
| 92081 |
|
520 |
518 |
$2K |
| 81002 |
|
747 |
727 |
$2K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
373 |
291 |
$2K |
| 92552 |
|
509 |
507 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90658 |
|
55 |
55 |
$732.63 |
| 86580 |
|
197 |
191 |
$604.02 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$495.00 |
| 90756 |
|
78 |
76 |
$475.90 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
69 |
53 |
$319.30 |
| 90656 |
|
83 |
83 |
$296.32 |
| 82947 |
|
28 |
28 |
$90.90 |
| 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 |
14 |
12 |
$36.79 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
136 |
116 |
$0.00 |
| 3079F |
|
96 |
88 |
$0.00 |
| 3074F |
|
251 |
223 |
$0.00 |
| 3075F |
|
29 |
27 |
$0.00 |
| 3080F |
|
36 |
34 |
$0.00 |
| 3078F |
|
129 |
121 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
19 |
19 |
$0.00 |