| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
25,280 |
18,706 |
$2.07M |
| 99199 |
Unlisted special service, procedure or report |
102,904 |
61,971 |
$606K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
822 |
751 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,876 |
11,160 |
$46K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
768 |
587 |
$44K |
| 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 |
2,190 |
1,595 |
$44K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
315 |
273 |
$21K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,487 |
1,317 |
$15K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
649 |
599 |
$14K |
| 92552 |
|
909 |
841 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,776 |
2,153 |
$9K |
| D0145 |
Oral evaluation for a patient under three years of age |
194 |
192 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
139 |
122 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
686 |
653 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
121 |
111 |
$4K |
| D1206 |
Topical application of fluoride varnish |
197 |
194 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
38 |
$3K |
| 87428 |
|
23 |
19 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
158 |
123 |
$245.73 |
| 99173 |
|
463 |
407 |
$15.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
114 |
101 |
$14.57 |
| 90670 |
|
226 |
199 |
$0.00 |
| 90633 |
|
74 |
66 |
$0.00 |
| 90649 |
|
30 |
24 |
$0.00 |
| 90648 |
|
190 |
172 |
$0.00 |
| 90700 |
|
40 |
32 |
$0.00 |
| 90713 |
|
24 |
16 |
$0.00 |
| 90734 |
|
15 |
12 |
$0.00 |
| 90756 |
|
40 |
33 |
$0.00 |
| 90710 |
|
51 |
43 |
$0.00 |
| 90696 |
|
14 |
13 |
$0.00 |
| 90686 |
|
491 |
446 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,273 |
1,162 |
$0.00 |
| 90723 |
|
138 |
124 |
$0.00 |
| 90651 |
|
16 |
14 |
$0.00 |
| 90680 |
|
14 |
13 |
$0.00 |