| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,105 |
3,760 |
$429K |
| 0011A |
|
31 |
31 |
$372.26 |
| 0012A |
|
14 |
14 |
$233.22 |
| 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 |
682 |
661 |
$195.00 |
| 0064A |
|
14 |
13 |
$80.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,097 |
1,982 |
$66.14 |
| 3074F |
|
50 |
50 |
$25.00 |
| 3078F |
|
59 |
59 |
$25.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
371 |
366 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
975 |
928 |
$0.00 |
| 3079F |
|
27 |
27 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |
| 91306 |
|
16 |
14 |
$0.00 |
| 3044F |
|
26 |
26 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
262 |
256 |
$0.00 |
| 3077F |
|
12 |
12 |
$0.00 |