| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,622 |
7,592 |
$313K |
| 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 |
853 |
728 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,247 |
2,577 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
907 |
755 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,289 |
1,063 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
350 |
284 |
$3K |
| 90750 |
|
96 |
68 |
$3K |
| 90658 |
|
199 |
199 |
$1K |
| 93000 |
|
87 |
73 |
$875.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
604 |
337 |
$252.68 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$59.00 |
| 90688 |
|
32 |
26 |
$50.00 |
| 97014 |
|
587 |
327 |
$18.10 |
| 97124 |
|
595 |
331 |
$0.00 |
| 90686 |
|
128 |
112 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
63 |
57 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
85 |
81 |
$0.00 |
| 98940 |
|
521 |
287 |
$0.00 |
| 97012 |
|
443 |
241 |
$0.00 |
| 92015 |
Determination of refractive state |
59 |
59 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
36 |
25 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
14 |
$0.00 |