| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,822 |
4,003 |
$824K |
| 87428 |
|
967 |
603 |
$39K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
120 |
80 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
161 |
101 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
72 |
66 |
$3K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
17 |
17 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
35 |
33 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
26 |
$1K |
| 0002A |
|
23 |
23 |
$880.00 |
| 90686 |
|
79 |
74 |
$832.96 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
16 |
$789.74 |
| 90734 |
|
41 |
41 |
$459.94 |
| 90715 |
|
12 |
12 |
$144.54 |
| Q3014 |
Telehealth originating site facility fee |
57 |
31 |
$66.04 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20 |
17 |
$59.18 |
| 87430 |
|
80 |
77 |
$13.11 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
19 |
16 |
$6.98 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
102 |
99 |
$0.00 |