| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
44,840 |
37,170 |
$6.81M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25,684 |
22,086 |
$1.00M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,925 |
6,302 |
$265K |
| D0999 |
Unspecified diagnostic procedure, by report |
682 |
623 |
$115K |
| 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 |
1,966 |
1,744 |
$63K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
715 |
692 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
483 |
437 |
$19K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
441 |
385 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
195 |
190 |
$6K |
| 90832 |
Psychotherapy, 30 minutes with patient |
237 |
211 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
850 |
826 |
$5K |
| 90791 |
Psychiatric diagnostic evaluation |
102 |
96 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,058 |
1,026 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
120 |
108 |
$3K |
| 99215 |
Prolong outpt/office vis |
78 |
72 |
$2K |
| 97169 |
|
94 |
88 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
28 |
27 |
$773.50 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
257 |
252 |
$450.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,063 |
947 |
$182.00 |
| V2025 |
Deluxe frame |
12 |
12 |
$98.45 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$83.04 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$52.90 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
487 |
469 |
$0.57 |
| D1120 |
Prophylaxis - child |
51 |
51 |
$0.00 |
| 3077F |
|
33 |
31 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
199 |
138 |
$0.00 |
| 1160F |
|
354 |
332 |
$0.00 |
| 1159F |
|
446 |
420 |
$0.00 |
| 90734 |
|
41 |
41 |
$0.00 |
| 81025 |
|
127 |
121 |
$0.00 |
| 3078F |
|
18 |
18 |
$0.00 |
| 90710 |
|
16 |
12 |
$0.00 |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$0.00 |
| D0603 |
|
129 |
128 |
$0.00 |
| D1330 |
|
155 |
154 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
467 |
455 |
$0.00 |
| 3079F |
|
148 |
140 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
71 |
63 |
$0.00 |
| 3080F |
|
14 |
13 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
138 |
135 |
$0.00 |
| 1170F |
|
237 |
224 |
$0.00 |
| 3074F |
|
101 |
100 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |
| 1126F |
|
429 |
398 |
$0.00 |
| 3075F |
|
50 |
45 |
$0.00 |
| 1125F |
|
19 |
17 |
$0.00 |
| 90686 |
|
18 |
18 |
$0.00 |
| 90651 |
|
33 |
33 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13 |
12 |
$0.00 |