| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
40,831 |
36,266 |
$2.21M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,963 |
15,050 |
$157K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,163 |
11,308 |
$74K |
| 90670 |
|
657 |
656 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,144 |
1,141 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,616 |
1,589 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,365 |
1,286 |
$16K |
| 90686 |
|
2,419 |
2,401 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,963 |
2,952 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
957 |
955 |
$13K |
| 90671 |
|
419 |
419 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
660 |
660 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
370 |
367 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,820 |
2,790 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
312 |
309 |
$4K |
| 90651 |
|
228 |
225 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
313 |
313 |
$4K |
| 91322 |
|
44 |
44 |
$4K |
| 90739 |
|
51 |
51 |
$4K |
| 90715 |
|
222 |
222 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
368 |
263 |
$2K |
| 98967 |
|
143 |
104 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
531 |
375 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
937 |
836 |
$2K |
| 90732 |
|
24 |
24 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
833 |
818 |
$1K |
| 98966 |
|
184 |
138 |
$1K |
| 90480 |
|
60 |
60 |
$1K |
| 90734 |
|
82 |
82 |
$1K |
| 0054A |
|
46 |
46 |
$975.78 |
| 99215 |
Prolong outpt/office vis |
155 |
149 |
$933.17 |
| 90656 |
|
130 |
130 |
$899.60 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
353 |
353 |
$874.18 |
| 81003 |
|
2,608 |
2,573 |
$846.17 |
| 90716 |
|
13 |
13 |
$817.56 |
| 96127 |
|
1,520 |
1,296 |
$798.73 |
| 0004A |
|
26 |
26 |
$643.45 |
| 85018 |
|
1,748 |
1,739 |
$625.38 |
| 90707 |
|
13 |
13 |
$462.90 |
| 99383 |
|
12 |
12 |
$404.00 |
| 0124A |
|
56 |
56 |
$350.91 |
| 0001A |
|
14 |
14 |
$340.65 |
| 0064A |
|
12 |
12 |
$340.65 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
178 |
176 |
$340.40 |
| 0002A |
|
13 |
13 |
$264.95 |
| 0051A |
|
14 |
14 |
$262.71 |
| 0052A |
|
15 |
15 |
$225.18 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
348 |
347 |
$209.04 |
| G9007 |
Coordinated care fee, scheduled team conference |
14 |
13 |
$164.65 |
| J2930 |
Injection, methylprednisolone sodium succinate, up to 125 mg |
60 |
55 |
$130.56 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
60 |
59 |
$84.00 |
| 87428 |
|
13 |
12 |
$51.24 |
| 90834 |
Psychotherapy, 45 minutes with patient |
36 |
27 |
$48.73 |
| 36416 |
|
2,007 |
1,997 |
$18.99 |
| Q3014 |
Telehealth originating site facility fee |
26 |
26 |
$16.14 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
13 |
$9.44 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
14 |
14 |
$8.80 |
| 90723 |
|
225 |
224 |
$0.00 |
| 90680 |
|
170 |
170 |
$0.00 |
| 90698 |
|
123 |
123 |
$0.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
47 |
45 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
13 |
13 |
$0.00 |
| 90461 |
|
1,569 |
1,566 |
$0.00 |
| 99173 |
|
1,048 |
1,047 |
$0.00 |
| 90648 |
|
415 |
415 |
$0.00 |
| 91300 |
|
141 |
129 |
$0.00 |
| 90633 |
|
84 |
84 |
$0.00 |
| 90685 |
|
13 |
13 |
$0.00 |