| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
18,730 |
12,641 |
$3.28M |
| 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 |
5,759 |
4,859 |
$336K |
| 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 |
844 |
824 |
$81K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
748 |
658 |
$53K |
| D1120 |
Prophylaxis - child |
1,266 |
1,219 |
$46K |
| D1110 |
Prophylaxis - adult |
1,170 |
1,082 |
$36K |
| D0120 |
Periodic oral evaluation - established patient |
1,327 |
1,261 |
$30K |
| D1206 |
Topical application of fluoride varnish |
1,846 |
1,774 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,391 |
6,259 |
$13K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
185 |
164 |
$8K |
| D0274 |
Bitewings - four radiographic images |
535 |
495 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,591 |
4,035 |
$7K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,339 |
1,148 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
92 |
73 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
192 |
146 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
2,622 |
2,461 |
$3K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
51 |
25 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
45 |
39 |
$2K |
| D0272 |
Bitewings - two radiographic images |
66 |
65 |
$2K |
| 90837 |
Psychotherapy, 53 minutes with patient |
427 |
189 |
$2K |
| G0008 |
Administration of influenza virus vaccine |
411 |
397 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
348 |
320 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
58 |
52 |
$1K |
| 0002A |
|
20 |
20 |
$745.80 |
| 0001A |
|
14 |
14 |
$522.06 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
26 |
26 |
$456.88 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
184 |
163 |
$296.04 |
| 90791 |
Psychiatric diagnostic evaluation |
22 |
13 |
$282.30 |
| 11721 |
|
468 |
463 |
$177.54 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
836 |
800 |
$174.92 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
95 |
94 |
$37.46 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
55 |
42 |
$28.00 |
| 99000 |
|
619 |
508 |
$2.46 |
| 80305 |
|
16 |
15 |
$0.00 |
| 99334 |
|
60 |
59 |
$0.00 |
| 90653 |
|
27 |
27 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
26 |
15 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
71 |
68 |
$0.00 |
| 91300 |
|
34 |
20 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
33 |
26 |
$0.00 |
| 90756 |
|
40 |
23 |
$0.00 |
| 90661 |
|
13 |
13 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
78 |
68 |
$0.00 |
| 90674 |
|
93 |
90 |
$0.00 |
| 0031A |
|
61 |
61 |
$0.00 |
| 91303 |
|
61 |
61 |
$0.00 |
| 91301 |
|
26 |
26 |
$0.00 |