| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
21,818 |
17,777 |
$4.97M |
| G9012 |
Other specified case management service not elsewhere classified |
2,829 |
2,799 |
$745K |
| 3074F |
|
1,674 |
1,582 |
$2K |
| 3078F |
|
1,450 |
1,374 |
$2K |
| 3079F |
|
542 |
518 |
$1K |
| 3077F |
|
274 |
260 |
$936.79 |
| 3075F |
|
319 |
306 |
$556.93 |
| 3080F |
|
132 |
131 |
$360.00 |
| 3044F |
|
54 |
53 |
$239.91 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,622 |
4,230 |
$225.12 |
| 3725F |
|
727 |
698 |
$100.00 |
| 90686 |
|
687 |
512 |
$10.00 |
| 1160F |
|
3,868 |
3,635 |
$0.00 |
| 1159F |
|
2,855 |
2,716 |
$0.00 |
| 96160 |
|
653 |
581 |
$0.00 |
| 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 |
157 |
142 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
204 |
191 |
$0.00 |
| 80305 |
|
608 |
529 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
173 |
171 |
$0.00 |
| 90714 |
|
13 |
13 |
$0.00 |
| 99173 |
|
86 |
86 |
$0.00 |
| 81025 |
|
14 |
13 |
$0.00 |
| 90713 |
|
12 |
12 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
14 |
14 |
$0.00 |
| 81002 |
|
33 |
27 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
865 |
849 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,659 |
2,497 |
$0.00 |
| 3008F |
|
3,126 |
2,949 |
$0.00 |
| 82962 |
|
20 |
19 |
$0.00 |
| 96127 |
|
1,035 |
891 |
$0.00 |
| 92551 |
|
84 |
83 |
$0.00 |
| 99406 |
|
36 |
27 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
155 |
153 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
160 |
159 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
45 |
40 |
$0.00 |
| 90688 |
|
52 |
52 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
30 |
28 |
$0.00 |