| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
19,999 |
17,419 |
$3.92M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
848 |
830 |
$157K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
670 |
651 |
$123K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
296 |
285 |
$53K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
348 |
332 |
$52K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
1,434 |
1,057 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
524 |
470 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
228 |
196 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,688 |
1,648 |
$3K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
65 |
41 |
$2K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
61 |
61 |
$972.26 |
| 90670 |
|
572 |
562 |
$574.22 |
| 90474 |
|
123 |
119 |
$570.21 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
13 |
12 |
$421.87 |
| 90651 |
|
43 |
43 |
$389.92 |
| 90686 |
|
216 |
213 |
$202.37 |
| 90648 |
|
430 |
422 |
$194.96 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,152 |
1,124 |
$190.95 |
| 90633 |
|
76 |
76 |
$188.31 |
| 90723 |
|
184 |
181 |
$188.31 |
| 90680 |
|
156 |
154 |
$188.31 |
| 90685 |
|
56 |
55 |
$0.00 |
| 90734 |
|
58 |
57 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 99173 |
|
15 |
15 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
21 |
19 |
$0.00 |
| 90677 |
|
25 |
25 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |