| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
15,450 |
12,116 |
$2.77M |
| T1015 |
Clinic visit/encounter, all-inclusive |
19,176 |
17,311 |
$2.31M |
| 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 |
154 |
102 |
$2K |
| 0011A |
|
32 |
29 |
$1K |
| 0012A |
|
31 |
28 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,267 |
1,146 |
$550.96 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,662 |
4,698 |
$535.12 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,063 |
3,761 |
$450.29 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
25 |
$244.69 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
61 |
60 |
$111.13 |
| 90715 |
|
36 |
27 |
$40.78 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
43 |
42 |
$30.89 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
28 |
27 |
$30.87 |
| 90656 |
|
214 |
181 |
$10.80 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
65 |
$0.00 |
| 99173 |
|
133 |
118 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
19 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$0.00 |
| 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 |
33 |
27 |
$0.00 |
| 81003 |
|
18 |
14 |
$0.00 |
| 81025 |
|
16 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
30 |
$0.00 |
| 85018 |
|
184 |
167 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
29 |
24 |
$0.00 |
| 92551 |
|
144 |
130 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
595 |
514 |
$0.00 |
| 90651 |
|
15 |
14 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
111 |
104 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
109 |
85 |
$0.00 |
| 90686 |
|
19 |
14 |
$0.00 |