| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
53,784 |
30,873 |
$12.55M |
| 99442 |
|
3,909 |
3,564 |
$4K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
581 |
234 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,749 |
3,440 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
276 |
267 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,634 |
1,560 |
$469.00 |
| 99443 |
|
255 |
246 |
$376.11 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
84 |
83 |
$185.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
24 |
24 |
$132.28 |
| 81025 |
|
110 |
109 |
$88.40 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
39 |
$80.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
737 |
727 |
$65.00 |
| 99441 |
|
103 |
100 |
$42.21 |
| 90461 |
|
363 |
362 |
$30.00 |
| 92551 |
|
343 |
340 |
$8.00 |
| 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 |
65 |
29 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
131 |
129 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
31 |
30 |
$0.00 |
| 3077F |
|
243 |
222 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
85 |
75 |
$0.00 |
| 0502F |
|
29 |
24 |
$0.00 |
| 90670 |
|
15 |
15 |
$0.00 |
| 90648 |
|
15 |
15 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |
| 3078F |
|
13 |
12 |
$0.00 |
| 3046F |
|
15 |
13 |
$0.00 |
| 99173 |
|
18 |
18 |
$0.00 |
| 3511F |
|
13 |
12 |
$0.00 |
| 3008F |
|
4,784 |
4,443 |
$0.00 |
| 3079F |
|
188 |
179 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
820 |
782 |
$0.00 |
| 90686 |
|
307 |
306 |
$0.00 |
| 4010F |
|
18 |
12 |
$0.00 |
| 3080F |
|
77 |
69 |
$0.00 |
| 1111F |
|
132 |
119 |
$0.00 |
| 90651 |
|
58 |
58 |
$0.00 |
| 3074F |
|
52 |
49 |
$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 |
18 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| 90677 |
|
18 |
18 |
$0.00 |