| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
32,269 |
24,520 |
$19.42M |
| 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 |
9,817 |
7,049 |
$3.30M |
| 00003 |
Internal/system code - not a standard HCPCS code |
880 |
592 |
$633K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,018 |
14,348 |
$429K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,282 |
11,808 |
$308K |
| 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 |
228 |
158 |
$107K |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,228 |
2,404 |
$71K |
| 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 |
54 |
27 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,535 |
1,357 |
$3K |
| 97810 |
|
1,400 |
921 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
500 |
499 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,082 |
1,050 |
$1K |
| 90687 |
|
101 |
101 |
$991.74 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
644 |
640 |
$919.83 |
| 99215 |
Prolong outpt/office vis |
402 |
386 |
$855.02 |
| 99000 |
|
3,844 |
3,309 |
$663.02 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
120 |
120 |
$560.98 |
| 81003 |
|
378 |
361 |
$560.97 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
235 |
209 |
$560.95 |
| 90688 |
|
738 |
724 |
$451.94 |
| 97811 |
|
1,375 |
906 |
$117.17 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
95 |
90 |
$10.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
75 |
58 |
$1.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
260 |
127 |
$0.18 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
182 |
175 |
$0.09 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
366 |
365 |
$0.05 |
| 87807 |
|
85 |
83 |
$0.05 |
| 80305 |
|
3,238 |
2,785 |
$0.03 |
| 82962 |
|
28 |
28 |
$0.03 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
53 |
52 |
$0.01 |
| 97026 |
|
1,525 |
1,025 |
$0.01 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
15 |
14 |
$0.00 |
| D1110 |
Prophylaxis - adult |
101 |
101 |
$0.00 |
| A4550 |
Surgical trays |
12 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
38 |
33 |
$0.00 |
| 90658 |
|
54 |
54 |
$0.00 |
| D1120 |
Prophylaxis - child |
16 |
16 |
$0.00 |
| 90715 |
|
48 |
44 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
33 |
33 |
$0.00 |
| D9430 |
|
13 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
48 |
47 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
14 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
99 |
74 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,038 |
1,015 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
151 |
150 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
30 |
28 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
215 |
214 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
22 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
51 |
51 |
$0.00 |
| 90686 |
|
18 |
18 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
37 |
37 |
$0.00 |
| 17000 |
|
12 |
12 |
$0.00 |