| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
38,913 |
30,672 |
$1.37M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,437 |
14,845 |
$466K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,724 |
7,980 |
$424K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,641 |
1,723 |
$192K |
| 99215 |
Prolong outpt/office vis |
1,070 |
954 |
$93K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,359 |
1,359 |
$87K |
| 99205 |
Prolong outpt/office vis |
264 |
264 |
$26K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,761 |
3,713 |
$25K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
302 |
302 |
$22K |
| 90674 |
|
1,023 |
1,022 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,254 |
1,213 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
231 |
231 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
331 |
331 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
230 |
230 |
$12K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,283 |
1,275 |
$12K |
| 0012A |
|
275 |
275 |
$9K |
| 0011A |
|
285 |
285 |
$8K |
| 91322 |
|
52 |
50 |
$6K |
| 96127 |
|
2,122 |
2,072 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
653 |
623 |
$4K |
| 0013A |
|
96 |
96 |
$4K |
| 0001A |
|
99 |
99 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,167 |
1,158 |
$3K |
| 90480 |
|
56 |
54 |
$2K |
| 0002A |
|
83 |
83 |
$2K |
| 99417 |
Prolong home eval add 15m |
69 |
69 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
33 |
32 |
$2K |
| 98967 |
|
105 |
57 |
$1K |
| 90661 |
|
59 |
59 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
129 |
129 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
25 |
25 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
257 |
252 |
$852.06 |
| 90670 |
|
107 |
107 |
$690.42 |
| 0071A |
|
16 |
16 |
$605.60 |
| 0134A |
|
15 |
15 |
$562.95 |
| 90715 |
|
67 |
67 |
$514.65 |
| 90651 |
|
52 |
52 |
$458.69 |
| 0072A |
|
12 |
12 |
$454.20 |
| Q3014 |
Telehealth originating site facility fee |
27 |
27 |
$245.20 |
| 98966 |
|
17 |
12 |
$131.41 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
68 |
65 |
$126.59 |
| 99201 |
|
18 |
18 |
$49.92 |
| 90686 |
|
488 |
488 |
$0.01 |
| 1159F |
|
5,156 |
4,838 |
$0.00 |
| 4004F |
|
1,180 |
1,156 |
$0.00 |
| 3078F |
|
1,356 |
1,303 |
$0.00 |
| 3077F |
|
587 |
562 |
$0.00 |
| 90685 |
|
27 |
27 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 91300 |
|
118 |
113 |
$0.00 |
| 90756 |
|
12 |
12 |
$0.00 |
| 90633 |
|
63 |
63 |
$0.00 |
| 91313 |
|
15 |
15 |
$0.00 |
| 4013F |
|
19 |
19 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$0.00 |
| 3074F |
|
1,611 |
1,556 |
$0.00 |
| 3079F |
|
1,366 |
1,320 |
$0.00 |
| 3080F |
|
302 |
291 |
$0.00 |
| 3075F |
|
806 |
786 |
$0.00 |
| 1034F |
|
269 |
252 |
$0.00 |
| 90632 |
|
107 |
107 |
$0.00 |
| 1036F |
|
402 |
372 |
$0.00 |
| 3044F |
|
330 |
324 |
$0.00 |
| 91301 |
|
197 |
197 |
$0.00 |
| 3008F |
|
706 |
661 |
$0.00 |
| 90647 |
|
27 |
27 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 91307 |
|
28 |
28 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |