| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,042 |
7,533 |
$743K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,649 |
7,633 |
$546K |
| 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 |
1,322 |
1,204 |
$40K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
613 |
604 |
$38K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
495 |
474 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
398 |
397 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
212 |
211 |
$15K |
| 76801 |
|
30 |
24 |
$9K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
74 |
56 |
$9K |
| D1110 |
Prophylaxis - adult |
99 |
99 |
$8K |
| 90832 |
Psychotherapy, 30 minutes with patient |
202 |
109 |
$7K |
| 98940 |
|
495 |
184 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
227 |
168 |
$6K |
| 81003 |
|
302 |
268 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
108 |
108 |
$4K |
| 99490 |
Ccm add 20min |
584 |
407 |
$4K |
| 92551 |
|
56 |
56 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
28 |
25 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
42 |
24 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
28 |
28 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
41 |
39 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
39 |
38 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
116 |
97 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$1K |
| 82962 |
|
91 |
79 |
$1K |
| 81025 |
|
26 |
24 |
$457.84 |
| 99439 |
|
32 |
25 |
$436.21 |
| 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 |
27 |
14 |
$206.05 |
| H0049 |
Alcohol and/or drug screening |
19 |
14 |
$154.14 |
| 99406 |
|
13 |
12 |
$29.44 |
| 36415 |
Collection of venous blood by venipuncture |
471 |
446 |
$9.54 |
| 1000F |
|
3,425 |
2,613 |
$0.54 |
| 3008F |
|
6,060 |
4,386 |
$0.52 |
| 0513F |
|
297 |
280 |
$0.15 |
| 3351F |
|
120 |
106 |
$0.09 |
| 4004F |
|
179 |
158 |
$0.06 |
| G0008 |
Administration of influenza virus vaccine |
61 |
58 |
$0.00 |
| 2000F |
|
5,395 |
3,710 |
$0.00 |
| 2001F |
|
5,030 |
3,577 |
$0.00 |
| 3079F |
|
978 |
691 |
$0.00 |
| 3074F |
|
1,770 |
1,281 |
$0.00 |
| 1220F |
|
816 |
563 |
$0.00 |
| 3075F |
|
68 |
49 |
$0.00 |
| 3044F |
|
227 |
122 |
$0.00 |
| 1125F |
|
21 |
15 |
$0.00 |
| D1310 |
|
26 |
26 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
13 |
$0.00 |
| D1330 |
|
12 |
12 |
$0.00 |
| 1159F |
|
993 |
733 |
$0.00 |
| 3077F |
|
277 |
178 |
$0.00 |
| D1999 |
|
525 |
444 |
$0.00 |
| 3078F |
|
1,627 |
1,130 |
$0.00 |
| 2028F |
|
555 |
355 |
$0.00 |
| 1160F |
|
993 |
733 |
$0.00 |
| 90461 |
|
17 |
17 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21 |
21 |
$0.00 |
| 90662 |
|
13 |
13 |
$0.00 |