| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,622 |
5,848 |
$904K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,140 |
1,935 |
$104K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
855 |
826 |
$51K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
877 |
828 |
$35K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
419 |
408 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
236 |
235 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,824 |
849 |
$10K |
| 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 |
218 |
206 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
58 |
57 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
43 |
38 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
38 |
38 |
$3K |
| 90686 |
|
543 |
529 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
117 |
111 |
$1K |
| 90461 |
|
228 |
201 |
$855.49 |
| 87428 |
|
57 |
54 |
$840.34 |
| 81003 |
|
599 |
517 |
$639.13 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
437 |
427 |
$596.57 |
| 0002A |
|
47 |
47 |
$551.02 |
| 90651 |
|
86 |
86 |
$371.75 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
30 |
$333.36 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
55 |
51 |
$319.70 |
| 90734 |
|
66 |
66 |
$150.23 |
| 81025 |
|
88 |
88 |
$137.37 |
| 90715 |
|
38 |
37 |
$123.96 |
| 90656 |
|
61 |
60 |
$104.83 |
| 0001A |
|
22 |
22 |
$84.70 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$32.64 |
| 92551 |
|
98 |
95 |
$10.10 |
| 85018 |
|
12 |
12 |
$1.99 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
55 |
41 |
$0.00 |
| 99173 |
|
122 |
120 |
$0.00 |
| 3078F |
|
125 |
115 |
$0.00 |
| 90670 |
|
26 |
26 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
57 |
57 |
$0.00 |
| 91300 |
|
15 |
15 |
$0.00 |
| 3074F |
|
190 |
171 |
$0.00 |
| 3079F |
|
69 |
64 |
$0.00 |
| 3075F |
|
41 |
38 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |
| 96127 |
|
15 |
14 |
$0.00 |