| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
5,575 |
5,050 |
$912K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,639 |
7,536 |
$820K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,123 |
5,565 |
$686K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,918 |
1,556 |
$265K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,237 |
1,501 |
$263K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,241 |
1,099 |
$174K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
376 |
344 |
$57K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,333 |
3,396 |
$53K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,344 |
1,763 |
$36K |
| 99215 |
Prolong outpt/office vis |
199 |
163 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
173 |
102 |
$16K |
| 90474 |
|
705 |
503 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
408 |
339 |
$8K |
| 99177 |
|
389 |
364 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
107 |
100 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
273 |
230 |
$4K |
| 87807 |
|
147 |
115 |
$2K |
| 99442 |
|
15 |
14 |
$1K |
| 99441 |
|
12 |
12 |
$858.80 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
16 |
12 |
$710.95 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
20 |
14 |
$699.23 |
| 90686 |
|
133 |
93 |
$410.86 |
| 83655 |
|
31 |
26 |
$370.07 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$336.00 |
| 92551 |
|
61 |
54 |
$250.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
15 |
$184.32 |
| 81003 |
|
30 |
27 |
$124.76 |
| 85018 |
|
32 |
27 |
$95.89 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
25 |
15 |
$79.51 |
| 90723 |
|
788 |
574 |
$0.00 |
| 90680 |
|
729 |
521 |
$0.00 |
| 90651 |
|
26 |
24 |
$0.00 |
| 90710 |
|
40 |
38 |
$0.00 |
| 90648 |
|
1,858 |
791 |
$0.00 |
| 90633 |
|
226 |
180 |
$0.00 |
| 90734 |
|
17 |
14 |
$0.00 |