| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
939 |
839 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,064 |
1,115 |
$30K |
| 99385 |
|
103 |
60 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
30 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
52 |
41 |
$3K |
| H1000 |
Prenatal care, at-risk assessment |
54 |
48 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
82 |
80 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 93000 |
|
188 |
135 |
$977.95 |
| 99406 |
|
109 |
99 |
$764.28 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46 |
45 |
$320.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
38 |
25 |
$141.31 |
| 81002 |
|
82 |
80 |
$100.66 |
| 96160 |
|
78 |
75 |
$43.38 |
| 3351F |
|
1,763 |
952 |
$0.00 |
| 1170F |
|
382 |
210 |
$0.00 |
| 3017F |
|
42 |
40 |
$0.00 |
| 3074F |
|
250 |
209 |
$0.00 |
| 1000F |
|
2,095 |
1,320 |
$0.00 |
| 3049F |
|
16 |
16 |
$0.00 |
| 4010F |
|
446 |
436 |
$0.00 |
| 3044F |
|
155 |
153 |
$0.00 |
| 3075F |
|
34 |
33 |
$0.00 |
| 3008F |
|
2,453 |
1,438 |
$0.00 |
| 1126F |
|
267 |
261 |
$0.00 |
| 3079F |
|
86 |
85 |
$0.00 |
| 1034F |
|
77 |
73 |
$0.00 |
| 1036F |
|
104 |
102 |
$0.00 |
| 1157F |
|
53 |
51 |
$0.00 |
| 3014F |
|
15 |
13 |
$0.00 |
| 0513F |
|
39 |
39 |
$0.00 |
| 3048F |
|
24 |
24 |
$0.00 |
| 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 |
21 |
12 |
$0.00 |
| 90686 |
|
21 |
20 |
$0.00 |
| 3078F |
|
413 |
348 |
$0.00 |
| 4013F |
|
356 |
352 |
$0.00 |
| 1158F |
|
53 |
51 |
$0.00 |
| 1160F |
|
1,162 |
910 |
$0.00 |
| 1159F |
|
1,252 |
995 |
$0.00 |
| 3050F |
|
29 |
29 |
$0.00 |
| 4004F |
|
110 |
73 |
$0.00 |
| 3016F |
|
91 |
87 |
$0.00 |
| 3015F |
|
13 |
12 |
$0.00 |
| 3077F |
|
14 |
14 |
$0.00 |