| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
30,045 |
25,339 |
$6.41M |
| 0012A |
|
133 |
133 |
$5K |
| 0011A |
|
124 |
124 |
$4K |
| G9012 |
Other specified case management service not elsewhere classified |
12 |
12 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
93 |
91 |
$598.00 |
| 0064A |
|
15 |
15 |
$531.64 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42 |
40 |
$225.00 |
| 0134A |
|
15 |
15 |
$120.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
48 |
46 |
$36.82 |
| 3016F |
|
3,455 |
3,298 |
$0.00 |
| 3725F |
|
4,056 |
3,832 |
$0.00 |
| 92552 |
|
1,147 |
1,140 |
$0.00 |
| 3078F |
|
211 |
207 |
$0.00 |
| 80305 |
|
325 |
270 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,376 |
1,370 |
$0.00 |
| 1160F |
|
3,598 |
3,380 |
$0.00 |
| 99173 |
|
1,229 |
1,222 |
$0.00 |
| 90670 |
|
27 |
16 |
$0.00 |
| 96160 |
|
321 |
318 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
25 |
$0.00 |
| 3077F |
|
189 |
189 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 3080F |
|
114 |
114 |
$0.00 |
| 36416 |
|
354 |
349 |
$0.00 |
| 1034F |
|
196 |
189 |
$0.00 |
| 3008F |
|
615 |
600 |
$0.00 |
| 86701 |
|
96 |
96 |
$0.00 |
| 90688 |
|
210 |
158 |
$0.00 |
| 1036F |
|
719 |
695 |
$0.00 |
| 96127 |
|
341 |
337 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
559 |
549 |
$0.00 |
| 86803 |
|
26 |
25 |
$0.00 |
| 4037F |
|
13 |
13 |
$0.00 |
| 3075F |
|
69 |
68 |
$0.00 |
| 3074F |
|
192 |
187 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
71 |
69 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
74 |
72 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
94 |
94 |
$0.00 |
| 3079F |
|
171 |
170 |
$0.00 |
| 85018 |
|
26 |
26 |
$0.00 |
| 1035F |
|
13 |
13 |
$0.00 |
| 90698 |
|
26 |
15 |
$0.00 |
| 3044F |
|
21 |
21 |
$0.00 |