| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
36,114 |
28,990 |
$6.24M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,014 |
14,747 |
$208K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,472 |
18,545 |
$170K |
| 98928 |
|
621 |
487 |
$9K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
145 |
143 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,713 |
1,407 |
$7K |
| 59426 |
|
844 |
527 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
210 |
170 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
345 |
273 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
278 |
268 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
187 |
184 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,212 |
1,099 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
337 |
281 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
55 |
46 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,101 |
3,703 |
$892.42 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
889 |
761 |
$847.30 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
953 |
849 |
$669.74 |
| 99215 |
Prolong outpt/office vis |
67 |
53 |
$494.39 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
480 |
378 |
$401.93 |
| 90715 |
|
491 |
418 |
$305.43 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$276.30 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
12 |
12 |
$241.18 |
| 99349 |
|
24 |
21 |
$185.44 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,151 |
1,932 |
$180.06 |
| 90686 |
|
685 |
618 |
$95.59 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
128 |
125 |
$94.55 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
27 |
25 |
$65.55 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
13 |
12 |
$43.50 |
| 99443 |
|
15 |
15 |
$21.80 |
| 90670 |
|
671 |
653 |
$0.03 |
| 90698 |
|
287 |
271 |
$0.02 |
| 90744 |
|
80 |
80 |
$0.01 |
| 90651 |
|
76 |
59 |
$0.01 |
| 90633 |
|
206 |
170 |
$0.01 |
| 90710 |
|
121 |
106 |
$0.01 |
| 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 |
29 |
29 |
$0.01 |
| 90656 |
|
16 |
16 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| 90696 |
|
42 |
41 |
$0.00 |
| J3490 |
Unclassified drugs |
38 |
38 |
$0.00 |
| 90734 |
|
306 |
261 |
$0.00 |
| 90685 |
|
39 |
39 |
$0.00 |
| 99442 |
|
25 |
25 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90649 |
|
13 |
13 |
$0.00 |