| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
41,783 |
34,159 |
$6.58M |
| 87428 |
|
2,922 |
2,378 |
$148K |
| 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 |
2,528 |
2,070 |
$55K |
| 87426 |
|
1,164 |
1,065 |
$41K |
| 99392 |
|
1,004 |
725 |
$35K |
| 99393 |
|
1,077 |
738 |
$34K |
| 99394 |
|
709 |
466 |
$22K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
279 |
237 |
$21K |
| 81025 |
|
2,877 |
2,156 |
$7K |
| 99391 |
|
129 |
114 |
$7K |
| 99213 |
|
2,832 |
2,327 |
$7K |
| 90686 |
|
329 |
294 |
$4K |
| 90633 |
|
272 |
247 |
$3K |
| 90670 |
|
230 |
210 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
97 |
67 |
$2K |
| 90710 |
|
167 |
163 |
$2K |
| 90651 |
|
154 |
133 |
$1K |
| 90734 |
|
123 |
107 |
$1K |
| 90696 |
|
61 |
60 |
$748.98 |
| 90715 |
|
95 |
83 |
$726.40 |
| 90723 |
|
66 |
64 |
$580.76 |
| 90647 |
|
54 |
50 |
$479.14 |
| 90697 |
|
30 |
29 |
$411.81 |
| 90677 |
|
33 |
31 |
$381.06 |
| 90656 |
|
123 |
102 |
$315.48 |
| 36415 |
|
1,081 |
961 |
$252.12 |
| 96372 |
|
740 |
627 |
$199.64 |
| 90648 |
|
17 |
14 |
$186.04 |
| 99401 |
|
18 |
12 |
$165.00 |
| 90619 |
|
51 |
38 |
$131.40 |
| 99395 |
|
79 |
61 |
$122.02 |
| 90700 |
|
16 |
13 |
$114.72 |
| 90655 |
|
14 |
13 |
$105.16 |
| Q3014 |
Telehealth originating site facility fee |
50 |
43 |
$86.36 |
| 81003 |
|
1,303 |
1,165 |
$61.09 |
| 80305 |
|
458 |
400 |
$39.30 |
| 87804 |
|
1,251 |
1,168 |
$28.00 |
| 87430 |
|
368 |
348 |
$26.22 |
| 83036 |
|
453 |
426 |
$19.44 |
| 82947 |
|
124 |
116 |
$14.82 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
753 |
716 |
$8.57 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
43 |
38 |
$3.24 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
899 |
851 |
$0.24 |
| 1160F |
|
1,875 |
1,566 |
$0.07 |
| 87880 |
|
1,637 |
1,538 |
$0.00 |
| 81002 |
|
172 |
127 |
$0.00 |
| 1159F |
|
35 |
35 |
$0.00 |
| 85025 |
|
30 |
30 |
$0.00 |
| 87807 |
|
344 |
312 |
$0.00 |
| T1014 |
Telehealth transmission, per minute, professional services bill separately |
112 |
107 |
$0.00 |
| 3351F |
|
54 |
52 |
$0.00 |
| 99214 |
|
38 |
37 |
$0.00 |
| 82044 |
|
49 |
49 |
$0.00 |
| 87086 |
|
185 |
172 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12 |
12 |
$0.00 |
| 99441 |
|
12 |
12 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |