| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,162 |
7,370 |
$556K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,007 |
4,652 |
$158K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,896 |
1,221 |
$59K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
703 |
402 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
154 |
103 |
$2K |
| 99051 |
|
200 |
127 |
$1K |
| 90686 |
|
295 |
157 |
$734.85 |
| 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 |
57 |
48 |
$571.20 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
23 |
12 |
$472.56 |
| 81003 |
|
338 |
144 |
$308.94 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
36 |
26 |
$257.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
15 |
$186.52 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
39 |
26 |
$139.15 |
| 96127 |
|
15 |
13 |
$46.44 |
| 3074F |
|
970 |
789 |
$0.07 |
| 3078F |
|
781 |
647 |
$0.03 |
| 3008F |
|
613 |
439 |
$0.01 |
| 1036F |
|
377 |
321 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
118 |
79 |
$0.00 |
| 3079F |
|
41 |
38 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
17 |
14 |
$0.00 |