| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
39,796 |
26,020 |
$4.75M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,538 |
10,506 |
$338K |
| 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 |
1,381 |
1,191 |
$125K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,195 |
4,010 |
$115K |
| 92552 |
|
2,015 |
1,682 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
137 |
137 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
102 |
102 |
$4K |
| 99173 |
|
889 |
889 |
$3K |
| 81003 |
|
3,167 |
2,819 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
453 |
367 |
$3K |
| 90686 |
|
160 |
158 |
$3K |
| 92551 |
|
339 |
336 |
$2K |
| 85018 |
|
3,263 |
2,840 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62 |
62 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
386 |
285 |
$2K |
| 90656 |
|
138 |
138 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
409 |
298 |
$2K |
| 59425 |
|
19 |
13 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
141 |
140 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54 |
53 |
$1K |
| 90715 |
|
13 |
13 |
$630.61 |
| 82962 |
|
259 |
232 |
$377.61 |
| 90688 |
|
19 |
19 |
$364.80 |
| 90658 |
|
63 |
60 |
$356.40 |
| 99401 |
|
24 |
24 |
$282.60 |
| 1160F |
|
252 |
220 |
$242.68 |
| 1159F |
|
271 |
236 |
$242.63 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
29 |
28 |
$188.70 |
| 90734 |
|
16 |
16 |
$172.80 |
| 97803 |
|
12 |
12 |
$121.08 |
| 86580 |
|
31 |
30 |
$104.16 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
26 |
26 |
$90.86 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$83.22 |
| 87807 |
|
12 |
12 |
$82.32 |
| 81025 |
|
25 |
24 |
$69.27 |
| 82948 |
|
172 |
159 |
$41.04 |
| 3078F |
|
293 |
286 |
$30.38 |
| 3074F |
|
301 |
291 |
$30.38 |
| 81002 |
|
48 |
48 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
166 |
161 |
$0.00 |
| 3079F |
|
70 |
68 |
$0.00 |
| 3075F |
|
40 |
38 |
$0.00 |
| 99070 |
|
61 |
58 |
$0.00 |
| Z1034 |
|
32 |
25 |
$0.00 |