| 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 |
1,687 |
1,306 |
$73K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,309 |
1,028 |
$18K |
| 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 |
147 |
147 |
$7K |
| 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 |
191 |
165 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
292 |
277 |
$5K |
| 90837 |
Psychotherapy, 53 minutes with patient |
44 |
33 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
112 |
112 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
15 |
$569.38 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
35 |
34 |
$425.03 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
15 |
15 |
$269.67 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
53 |
53 |
$238.00 |
| 82962 |
|
82 |
76 |
$171.60 |
| 81025 |
|
54 |
53 |
$170.64 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
25 |
25 |
$155.52 |
| 90688 |
|
14 |
14 |
$142.72 |
| 93000 |
|
20 |
20 |
$133.14 |
| 81002 |
|
109 |
105 |
$75.90 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$70.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
36 |
33 |
$51.84 |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
607 |
567 |
$0.00 |