| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
85,367 |
60,159 |
$11.08M |
| 0072A |
|
421 |
417 |
$18K |
| 0071A |
|
417 |
413 |
$18K |
| 0002A |
|
228 |
199 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
51,339 |
37,303 |
$8K |
| 0001A |
|
170 |
160 |
$7K |
| 0003A |
|
52 |
52 |
$2K |
| 0054A |
|
51 |
51 |
$2K |
| 0011A |
|
87 |
87 |
$1K |
| 90658 |
|
1,372 |
1,124 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,260 |
5,170 |
$1K |
| 90670 |
|
3,225 |
2,992 |
$897.59 |
| 0064A |
|
20 |
20 |
$842.80 |
| 0012A |
|
22 |
22 |
$624.58 |
| 0004A |
|
14 |
14 |
$589.96 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,293 |
4,006 |
$554.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,632 |
3,791 |
$532.45 |
| 99000 |
|
21 |
21 |
$492.66 |
| 90686 |
|
1,879 |
1,821 |
$405.83 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,249 |
3,954 |
$279.00 |
| 90791 |
Psychiatric diagnostic evaluation |
315 |
274 |
$267.87 |
| 99173 |
|
2,929 |
2,758 |
$253.00 |
| 90688 |
|
687 |
669 |
$231.33 |
| 90461 |
|
2,459 |
2,315 |
$220.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,886 |
4,347 |
$213.15 |
| 92551 |
|
2,363 |
2,202 |
$209.00 |
| 90715 |
|
666 |
588 |
$196.82 |
| 90716 |
|
603 |
552 |
$195.70 |
| 90633 |
|
1,459 |
1,360 |
$192.52 |
| 90734 |
|
270 |
245 |
$188.35 |
| 90649 |
|
134 |
122 |
$187.29 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,430 |
1,329 |
$180.00 |
| 85018 |
|
2,452 |
2,220 |
$171.64 |
| 90723 |
|
2,530 |
2,343 |
$170.80 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,234 |
2,064 |
$169.00 |
| 90648 |
|
1,482 |
1,392 |
$149.80 |
| 90707 |
|
594 |
552 |
$139.44 |
| 90680 |
|
2,339 |
2,171 |
$134.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
587 |
373 |
$109.54 |
| 81025 |
|
1,406 |
1,186 |
$104.48 |
| 90647 |
|
1,659 |
1,522 |
$96.23 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,038 |
948 |
$84.00 |
| 90700 |
|
470 |
448 |
$73.64 |
| 81002 |
|
1,082 |
895 |
$73.00 |
| 90696 |
|
462 |
443 |
$68.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
580 |
468 |
$61.00 |
| 90710 |
|
490 |
470 |
$59.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
997 |
923 |
$47.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
165 |
115 |
$44.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,006 |
879 |
$43.00 |
| 90651 |
|
261 |
245 |
$31.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
447 |
389 |
$30.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,196 |
2,692 |
$27.60 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
69 |
67 |
$23.00 |
| 59025 |
Fetal non-stress test |
198 |
111 |
$22.00 |
| 82962 |
|
589 |
524 |
$16.00 |
| 96127 |
|
336 |
301 |
$16.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
120 |
103 |
$15.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
382 |
360 |
$15.00 |
| 99201 |
|
36 |
33 |
$13.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
393 |
358 |
$13.00 |
| 90657 |
|
568 |
484 |
$12.80 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$10.00 |
| 76801 |
|
579 |
441 |
$10.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,201 |
752 |
$10.00 |
| 93000 |
|
12 |
12 |
$8.00 |
| 99381 |
|
446 |
415 |
$6.00 |
| 90863 |
|
148 |
83 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
34 |
13 |
$0.00 |
| 3078F |
|
556 |
451 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,624 |
1,079 |
$0.00 |
| 87210 |
|
170 |
147 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
629 |
383 |
$0.00 |
| 3077F |
|
60 |
53 |
$0.00 |
| 83026 |
|
402 |
354 |
$0.00 |
| 1159F |
|
39 |
29 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
17 |
12 |
$0.00 |
| 0502F |
|
38 |
29 |
$0.00 |
| 1160F |
|
12 |
12 |
$0.00 |
| 0503F |
|
187 |
170 |
$0.00 |
| 90474 |
|
22 |
22 |
$0.00 |
| 59430 |
|
94 |
92 |
$0.00 |
| 3008F |
|
763 |
623 |
$0.00 |
| 3074F |
|
562 |
449 |
$0.00 |
| 81005 |
|
472 |
445 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
112 |
86 |
$0.00 |
| 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 |
256 |
221 |
$0.00 |
| 3075F |
|
34 |
30 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
178 |
158 |
$0.00 |
| 1036F |
|
109 |
98 |
$0.00 |
| 3079F |
|
130 |
114 |
$0.00 |
| 4010F |
|
19 |
19 |
$0.00 |