| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
32,647 |
28,837 |
$4.62M |
| 00003 |
Internal/system code - not a standard HCPCS code |
23,096 |
19,546 |
$4.31M |
| 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 |
666 |
445 |
$26K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
186 |
126 |
$13K |
| 0011A |
|
17 |
17 |
$1K |
| 0012A |
|
15 |
15 |
$938.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,659 |
4,913 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
944 |
924 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
51 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
145 |
145 |
$0.00 |
| 99173 |
|
293 |
293 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
173 |
173 |
$0.00 |
| Z6300 |
|
12 |
12 |
$0.00 |
| 81025 |
|
12 |
12 |
$0.00 |
| 90670 |
|
28 |
28 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
124 |
124 |
$0.00 |
| Z6400 |
|
257 |
231 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
118 |
118 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
38 |
$0.00 |
| 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 |
117 |
79 |
$0.00 |
| Z6200 |
|
24 |
24 |
$0.00 |
| 81003 |
|
12 |
12 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,433 |
7,036 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
422 |
301 |
$0.00 |
| 92551 |
|
319 |
317 |
$0.00 |
| 90656 |
|
263 |
263 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
14 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
625 |
625 |
$0.00 |
| 85018 |
|
513 |
513 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,783 |
1,694 |
$0.00 |
| Z6406 |
|
12 |
12 |
$0.00 |
| Z6402 |
|
85 |
83 |
$0.00 |
| 90647 |
|
19 |
19 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
42 |
42 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |