| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
1,052 |
905 |
$70K |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
53 |
27 |
$16K |
| 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 |
136 |
129 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
561 |
507 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
329 |
313 |
$408.10 |
| 90707 |
|
29 |
29 |
$212.68 |
| 90716 |
|
14 |
14 |
$176.20 |
| 90746 |
|
20 |
20 |
$130.24 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
87 |
86 |
$112.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$88.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
159 |
154 |
$77.00 |
| 80305 |
|
48 |
41 |
$67.86 |
| 90632 |
|
32 |
32 |
$47.30 |
| 90715 |
|
64 |
61 |
$32.27 |
| 3074F |
|
99 |
93 |
$0.00 |
| 3725F |
|
37 |
34 |
$0.00 |
| 3078F |
|
92 |
87 |
$0.00 |
| G9002 |
Coordinated care fee, maintenance rate |
12 |
12 |
$0.00 |