| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
2,432 |
2,155 |
$325K |
| T1015 |
Clinic visit/encounter, all-inclusive |
3,923 |
3,490 |
$218K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,273 |
1,191 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
983 |
926 |
$6K |
| G9012 |
Other specified case management service not elsewhere classified |
23 |
14 |
$5K |
| 90686 |
|
105 |
105 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45 |
44 |
$1K |
| 90688 |
|
102 |
102 |
$931.30 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
71 |
71 |
$271.85 |
| 90685 |
|
28 |
28 |
$252.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
51 |
51 |
$185.44 |
| 92551 |
|
276 |
276 |
$157.08 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
22 |
15 |
$124.69 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
670 |
558 |
$119.29 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
41 |
$67.99 |
| 99173 |
|
30 |
30 |
$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 |
22 |
22 |
$0.00 |