| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,227 |
962 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
308 |
246 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$859.03 |
| 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 |
124 |
119 |
$786.99 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
15 |
$447.57 |
| 36415 |
Collection of venous blood by venipuncture |
499 |
351 |
$236.27 |
| 96127 |
|
178 |
144 |
$129.55 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
22 |
13 |
$67.20 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
41 |
39 |
$25.93 |
| 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 |
28 |
26 |
$14.50 |
| 81003 |
|
270 |
163 |
$13.00 |
| 82962 |
|
17 |
12 |
$10.49 |
| 3074F |
|
555 |
356 |
$10.01 |
| 3078F |
|
509 |
327 |
$10.00 |
| 96161 |
|
12 |
12 |
$2.14 |
| 3079F |
|
140 |
93 |
$0.02 |
| 3077F |
|
53 |
29 |
$0.01 |
| 1159F |
|
1,429 |
1,038 |
$0.00 |
| 1160F |
|
1,480 |
1,036 |
$0.00 |
| 0502F |
|
85 |
62 |
$0.00 |
| 3008F |
|
1,013 |
708 |
$0.00 |
| 3075F |
|
22 |
15 |
$0.00 |