| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,252 |
3,086 |
$296K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,145 |
2,392 |
$82K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
903 |
608 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
466 |
265 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
502 |
301 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
457 |
289 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
49 |
30 |
$2K |
| 90686 |
|
300 |
167 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
13 |
$1K |
| 80061 |
Lipid panel |
173 |
113 |
$869.20 |
| 90674 |
|
86 |
52 |
$827.30 |
| 99050 |
|
40 |
26 |
$337.47 |
| 90653 |
|
21 |
13 |
$300.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24 |
12 |
$295.37 |
| 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 |
15 |
12 |
$224.64 |
| 97810 |
|
32 |
12 |
$153.75 |
| D1208 |
Topical application of fluoride, excluding varnish |
26 |
13 |
$149.90 |
| 90658 |
|
49 |
27 |
$147.54 |
| 90656 |
|
21 |
12 |
$79.08 |
| 99408 |
|
47 |
31 |
$0.00 |