| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
19,967 |
16,742 |
$2.81M |
| 90837 |
Psychotherapy, 53 minutes with patient |
965 |
372 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,513 |
6,636 |
$28K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
302 |
183 |
$7K |
| 90834 |
Psychotherapy, 45 minutes with patient |
168 |
71 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,210 |
2,019 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
137 |
127 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
206 |
183 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
593 |
315 |
$757.72 |
| 90686 |
|
66 |
53 |
$658.86 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,683 |
2,239 |
$464.75 |
| 90677 |
|
21 |
12 |
$383.12 |
| 90688 |
|
28 |
28 |
$362.70 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
163 |
94 |
$336.51 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
46 |
$328.98 |
| 90648 |
|
40 |
24 |
$212.32 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
21 |
12 |
$138.76 |
| 83655 |
|
13 |
13 |
$138.19 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$102.48 |
| 90670 |
|
19 |
13 |
$99.00 |
| 81002 |
|
121 |
105 |
$63.64 |
| 92552 |
|
27 |
26 |
$50.49 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
25 |
$43.85 |
| 81025 |
|
13 |
12 |
$36.40 |
| 92551 |
|
126 |
68 |
$33.66 |
| 81003 |
|
27 |
14 |
$27.44 |
| 85018 |
|
87 |
86 |
$20.70 |
| 3078F |
|
927 |
850 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
30 |
30 |
$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 |
32 |
30 |
$0.00 |
| 99173 |
|
115 |
115 |
$0.00 |
| G0403 |
Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report |
14 |
14 |
$0.00 |
| 3079F |
|
446 |
422 |
$0.00 |
| 3074F |
|
1,800 |
1,635 |
$0.00 |
| 99000 |
|
79 |
69 |
$0.00 |