| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,799 |
6,495 |
$513K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,420 |
7,520 |
$418K |
| T1015 |
Clinic visit/encounter, all-inclusive |
10,193 |
8,731 |
$86K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
166 |
145 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
156 |
152 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
787 |
644 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,132 |
925 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
82 |
78 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
72 |
58 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
407 |
357 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
367 |
210 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
12 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
21 |
13 |
$2K |
| 90686 |
|
282 |
237 |
$976.25 |
| 99406 |
|
121 |
88 |
$967.43 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
13 |
$607.38 |
| 90649 |
|
17 |
12 |
$167.39 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
228 |
166 |
$0.02 |
| 3008F |
|
9,608 |
8,057 |
$0.00 |
| 1036F |
|
6,739 |
5,717 |
$0.00 |
| 1034F |
|
1,069 |
918 |
$0.00 |
| 1125F |
|
2,508 |
2,157 |
$0.00 |
| 1126F |
|
5,080 |
4,346 |
$0.00 |
| 3074F |
|
8,216 |
6,973 |
$0.00 |
| 1035F |
|
152 |
134 |
$0.00 |
| 3075F |
|
503 |
436 |
$0.00 |
| 3079F |
|
903 |
788 |
$0.00 |
| 1220F |
|
140 |
134 |
$0.00 |
| 3725F |
|
2,677 |
2,287 |
$0.00 |
| 1159F |
|
8,610 |
7,084 |
$0.00 |
| 1160F |
|
8,965 |
7,396 |
$0.00 |
| 3078F |
|
8,046 |
6,813 |
$0.00 |
| 3077F |
|
64 |
55 |
$0.00 |
| 90670 |
|
35 |
25 |
$0.00 |
| 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 |
23 |
14 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |