| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,356 |
6,668 |
$519K |
| 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 |
2,821 |
2,612 |
$97K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
126 |
$11K |
| 57454 |
|
37 |
37 |
$3K |
| 90715 |
|
100 |
100 |
$3K |
| 81025 |
|
333 |
328 |
$2K |
| 96127 |
|
253 |
216 |
$2K |
| 90686 |
|
161 |
161 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
147 |
143 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
60 |
60 |
$444.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54 |
54 |
$444.00 |
| 81002 |
|
86 |
80 |
$264.02 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$222.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
60 |
56 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,207 |
1,156 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
866 |
816 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| 92558 |
|
75 |
75 |
$0.00 |