| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,606 |
24,963 |
$6.43M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,474 |
3,122 |
$757K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,474 |
2,434 |
$557K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,030 |
987 |
$219K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
884 |
830 |
$150K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,366 |
1,226 |
$91K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
543 |
484 |
$13K |
| 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 |
941 |
881 |
$10K |
| 99307 |
|
341 |
285 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
49 |
49 |
$872.72 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
308 |
292 |
$86.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,955 |
4,817 |
$29.49 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
7,889 |
4,119 |
$14.85 |
| 90474 |
|
943 |
913 |
$0.00 |
| 90723 |
|
1,747 |
1,716 |
$0.00 |
| 90686 |
|
532 |
522 |
$0.00 |
| 90647 |
|
870 |
867 |
$0.00 |
| 90698 |
|
231 |
224 |
$0.00 |
| 90680 |
|
876 |
851 |
$0.00 |
| 90677 |
|
613 |
608 |
$0.00 |
| 90696 |
|
144 |
136 |
$0.00 |
| G0136 |
Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months |
12 |
12 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
39 |
39 |
$0.00 |
| 90651 |
|
125 |
118 |
$0.00 |
| 90716 |
|
80 |
77 |
$0.00 |
| 90744 |
|
40 |
39 |
$0.00 |
| 90670 |
|
2,052 |
2,009 |
$0.00 |
| 90633 |
|
1,185 |
1,166 |
$0.00 |
| 90648 |
|
1,064 |
1,032 |
$0.00 |
| 90700 |
|
431 |
428 |
$0.00 |
| 90681 |
|
552 |
550 |
$0.00 |
| 90710 |
|
677 |
659 |
$0.00 |
| 90473 |
|
515 |
510 |
$0.00 |
| 90715 |
|
160 |
154 |
$0.00 |
| 90734 |
|
220 |
213 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
41 |
38 |
$0.00 |
| 90707 |
|
68 |
67 |
$0.00 |
| 90649 |
|
13 |
12 |
$0.00 |