| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
30,362 |
25,135 |
$4.25M |
| 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 |
5,244 |
4,474 |
$993K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
3,388 |
1,710 |
$469K |
| 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 |
5,879 |
5,110 |
$181K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,311 |
1,307 |
$180K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
692 |
685 |
$120K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
414 |
413 |
$63K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,818 |
2,255 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
349 |
349 |
$55K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,830 |
1,812 |
$47K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
250 |
234 |
$42K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,055 |
2,051 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,522 |
2,494 |
$19K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
503 |
478 |
$16K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
448 |
422 |
$14K |
| 90686 |
|
1,221 |
1,218 |
$11K |
| 90461 |
|
448 |
448 |
$7K |
| 90688 |
|
413 |
413 |
$6K |
| 90715 |
|
223 |
223 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,523 |
2,348 |
$4K |
| 90677 |
|
41 |
41 |
$3K |
| 99050 |
|
47 |
45 |
$2K |
| 90480 |
|
60 |
60 |
$2K |
| 96127 |
|
219 |
219 |
$2K |
| 0012A |
|
45 |
45 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
194 |
182 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,817 |
2,545 |
$2K |
| 81025 |
|
246 |
241 |
$2K |
| 81002 |
|
361 |
345 |
$903.19 |
| 99443 |
|
30 |
30 |
$848.45 |
| 99188 |
|
26 |
26 |
$676.00 |
| 90651 |
|
37 |
37 |
$660.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
42 |
42 |
$630.62 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
112 |
111 |
$618.10 |
| 0124A |
|
13 |
13 |
$596.31 |
| 0001A |
|
12 |
12 |
$550.44 |
| 0002A |
|
12 |
12 |
$550.44 |
| 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 |
12 |
12 |
$522.17 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
52 |
52 |
$443.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
31 |
$354.30 |
| 90670 |
|
67 |
67 |
$215.00 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
24 |
24 |
$202.86 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$19.06 |
| 96160 |
|
25 |
25 |
$2.14 |
| 91320 |
|
34 |
34 |
$0.30 |
| 91322 |
|
36 |
36 |
$0.29 |
| G0008 |
Administration of influenza virus vaccine |
253 |
250 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
74 |
39 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
155 |
148 |
$0.00 |
| 91306 |
|
70 |
70 |
$0.00 |
| 90698 |
|
30 |
30 |
$0.00 |
| 91303 |
|
41 |
40 |
$0.00 |
| 91307 |
|
42 |
36 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |
| 91301 |
|
318 |
316 |
$0.00 |
| 90674 |
|
159 |
159 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
14 |
14 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90685 |
|
209 |
209 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
213 |
205 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
14 |
14 |
$0.00 |
| 91300 |
|
189 |
182 |
$0.00 |
| 90734 |
|
24 |
24 |
$0.00 |
| 90662 |
|
33 |
31 |
$0.00 |
| 91312 |
|
34 |
34 |
$0.00 |
| 90750 |
|
13 |
13 |
$0.00 |
| 90633 |
|
28 |
28 |
$0.00 |
| 91313 |
|
34 |
34 |
$0.00 |