| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,552 |
7,240 |
$955K |
| 3077F |
|
2,056 |
1,695 |
$190.00 |
| 3074F |
|
4,039 |
3,219 |
$170.00 |
| 3080F |
|
2,344 |
1,928 |
$165.00 |
| 3078F |
|
2,596 |
2,139 |
$155.00 |
| 3079F |
|
2,986 |
2,537 |
$130.00 |
| 3075F |
|
1,754 |
1,541 |
$90.00 |
| 3046F |
|
13 |
12 |
$10.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,576 |
5,874 |
$0.02 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,709 |
2,319 |
$0.01 |
| 1170F |
|
8,315 |
6,063 |
$0.00 |
| 1125F |
|
1,359 |
1,125 |
$0.00 |
| 1126F |
|
711 |
487 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
432 |
375 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
255 |
231 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
160 |
141 |
$0.00 |
| 3008F |
|
6,842 |
5,389 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
54 |
39 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
14 |
14 |
$0.00 |
| 90674 |
|
40 |
36 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
196 |
189 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
134 |
65 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
88 |
73 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
64 |
62 |
$0.00 |
| 90661 |
|
20 |
16 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
14 |
14 |
$0.00 |
| 90756 |
|
88 |
80 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
30 |
$0.00 |