| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
71,078 |
54,017 |
$12.61M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42,946 |
32,605 |
$440K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17,027 |
13,587 |
$146K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,572 |
6,737 |
$59K |
| 90686 |
|
2,655 |
2,353 |
$35K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
777 |
734 |
$34K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,335 |
2,254 |
$25K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,457 |
1,031 |
$19K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,190 |
2,876 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,271 |
1,169 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,190 |
1,069 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,197 |
1,072 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,416 |
2,005 |
$8K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
188 |
144 |
$5K |
| 90670 |
|
697 |
647 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
779 |
674 |
$5K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
103 |
60 |
$4K |
| 90633 |
|
194 |
188 |
$3K |
| 90698 |
|
274 |
263 |
$3K |
| 90632 |
|
55 |
54 |
$2K |
| 90680 |
|
185 |
173 |
$2K |
| 90744 |
|
127 |
124 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
83 |
74 |
$1K |
| 90656 |
|
122 |
121 |
$1K |
| 90715 |
|
344 |
296 |
$951.38 |
| 90651 |
|
221 |
204 |
$872.44 |
| 90746 |
|
17 |
16 |
$710.98 |
| 90700 |
|
28 |
27 |
$654.33 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
2,708 |
2,277 |
$286.94 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
100 |
97 |
$233.81 |
| 90710 |
|
129 |
115 |
$157.64 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
63 |
61 |
$136.22 |
| 99381 |
|
20 |
17 |
$130.79 |
| 90791 |
Psychiatric diagnostic evaluation |
90 |
85 |
$130.72 |
| 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 |
1,326 |
1,134 |
$98.41 |
| 99382 |
|
33 |
21 |
$72.29 |
| 90734 |
|
350 |
301 |
$70.71 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
671 |
598 |
$56.71 |
| 90696 |
|
37 |
29 |
$48.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$16.64 |
| 90648 |
|
397 |
356 |
$0.00 |
| 90473 |
|
29 |
26 |
$0.00 |
| 3078F |
|
507 |
422 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
13 |
13 |
$0.00 |
| 3074F |
|
936 |
755 |
$0.00 |
| 3008F |
|
667 |
533 |
$0.00 |
| 99496 |
|
32 |
30 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
47 |
27 |
$0.00 |
| 3079F |
|
68 |
41 |
$0.00 |
| 90677 |
|
97 |
96 |
$0.00 |
| 90723 |
|
105 |
90 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
29 |
28 |
$0.00 |
| 90688 |
|
35 |
33 |
$0.00 |
| 99383 |
|
19 |
12 |
$0.00 |