| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
23,742 |
20,716 |
$4.96M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,023 |
11,023 |
$304K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,740 |
2,608 |
$153K |
| G9012 |
Other specified case management service not elsewhere classified |
455 |
416 |
$150K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,067 |
1,378 |
$126K |
| J3490 |
Unclassified drugs |
1,874 |
1,569 |
$117K |
| 59425 |
|
1,159 |
842 |
$81K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,817 |
2,581 |
$50K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,987 |
1,625 |
$28K |
| 90686 |
|
1,106 |
897 |
$21K |
| 59430 |
|
327 |
242 |
$20K |
| 90715 |
|
654 |
553 |
$19K |
| 97803 |
|
690 |
519 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
864 |
795 |
$17K |
| 99401 |
|
1,235 |
888 |
$16K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
467 |
215 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
704 |
630 |
$15K |
| S4993 |
Contraceptive pills for birth control |
155 |
155 |
$13K |
| H1000 |
Prenatal care, at-risk assessment |
98 |
77 |
$12K |
| 99215 |
Prolong outpt/office vis |
77 |
77 |
$10K |
| 90688 |
|
708 |
708 |
$10K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
788 |
543 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
144 |
144 |
$9K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
694 |
514 |
$9K |
| 97810 |
|
335 |
256 |
$8K |
| 97811 |
|
332 |
255 |
$8K |
| 90651 |
|
222 |
173 |
$7K |
| 81025 |
|
2,254 |
2,051 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
321 |
287 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
265 |
189 |
$6K |
| 90670 |
|
717 |
638 |
$5K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$5K |
| 96156 |
|
378 |
245 |
$4K |
| H2000 |
Comprehensive multidisciplinary evaluation |
409 |
246 |
$4K |
| 97802 |
|
125 |
114 |
$4K |
| 90633 |
|
586 |
504 |
$4K |
| A4267 |
Contraceptive supply, condom, male, each |
357 |
357 |
$4K |
| 90698 |
|
541 |
481 |
$4K |
| 90744 |
|
518 |
442 |
$4K |
| 90691 |
|
88 |
88 |
$3K |
| 90716 |
|
262 |
234 |
$3K |
| 90707 |
|
161 |
156 |
$3K |
| 90685 |
|
251 |
250 |
$2K |
| 90681 |
|
213 |
194 |
$2K |
| 99403 |
|
141 |
101 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
45 |
38 |
$1K |
| 90743 |
|
22 |
17 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
125 |
118 |
$1K |
| 90700 |
|
100 |
91 |
$783.13 |
| 90656 |
|
36 |
36 |
$698.00 |
| 90713 |
|
53 |
40 |
$644.25 |
| 99402 |
|
22 |
15 |
$599.15 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
27 |
$572.00 |
| 90619 |
|
42 |
28 |
$552.51 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
2,222 |
1,871 |
$426.50 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$346.43 |
| 90734 |
|
38 |
38 |
$342.00 |
| 92551 |
|
410 |
409 |
$234.60 |
| 96151 |
|
22 |
19 |
$185.02 |
| S9452 |
Nutrition classes, non-physician provider, per session |
20 |
15 |
$168.20 |
| 96127 |
|
28 |
25 |
$134.68 |
| 86580 |
|
117 |
115 |
$114.24 |
| 90647 |
|
12 |
12 |
$108.00 |
| 85018 |
|
117 |
117 |
$86.11 |
| 81002 |
|
69 |
69 |
$83.85 |
| 81003 |
|
17 |
13 |
$36.27 |
| 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 |
44 |
41 |
$0.00 |