| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,108 |
973 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
574 |
529 |
$19K |
| 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 |
1,214 |
1,017 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
67 |
65 |
$6K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
39 |
28 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
47 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
257 |
256 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
132 |
132 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 99188 |
|
51 |
51 |
$929.90 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
32 |
$347.36 |
| 90686 |
|
55 |
54 |
$260.00 |
| 92551 |
|
429 |
379 |
$254.12 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
20 |
14 |
$218.79 |
| 85018 |
|
14 |
14 |
$22.82 |
| 99177 |
|
639 |
564 |
$15.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 99173 |
|
22 |
22 |
$0.00 |
| 36416 |
|
90 |
63 |
$0.00 |
| 1000F |
|
26 |
24 |
$0.00 |
| 96127 |
|
15 |
14 |
$0.00 |