| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
22,128 |
19,096 |
$3.69M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
9,959 |
8,326 |
$284K |
| 0761 |
|
2,488 |
2,018 |
$62K |
| 59425 |
|
778 |
479 |
$58K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,837 |
12,927 |
$49K |
| 0760 |
|
916 |
805 |
$39K |
| 0510 |
|
1,003 |
810 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
672 |
369 |
$16K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
627 |
548 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
545 |
320 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
335 |
178 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,519 |
3,126 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
374 |
195 |
$10K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
704 |
357 |
$9K |
| 99188 |
|
456 |
267 |
$5K |
| 90686 |
|
607 |
424 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
114 |
38 |
$4K |
| 81002 |
|
2,293 |
894 |
$3K |
| D1206 |
Topical application of fluoride varnish |
330 |
208 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
104 |
101 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
436 |
113 |
$2K |
| 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 |
86 |
86 |
$2K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
21 |
13 |
$2K |
| 90698 |
|
323 |
160 |
$2K |
| 90670 |
|
284 |
159 |
$2K |
| 90651 |
|
74 |
40 |
$1K |
| 92551 |
|
269 |
142 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,632 |
765 |
$895.87 |
| 81025 |
|
530 |
215 |
$841.93 |
| 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 |
77 |
65 |
$709.62 |
| G9920 |
Screening performed and negative |
249 |
171 |
$580.81 |
| 0071A |
|
13 |
13 |
$520.00 |
| 90715 |
|
73 |
40 |
$444.58 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
34 |
$268.45 |
| 90619 |
|
55 |
29 |
$261.00 |
| 90744 |
|
52 |
27 |
$234.00 |
| 99215 |
Prolong outpt/office vis |
318 |
172 |
$205.92 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
34 |
17 |
$180.40 |
| 90633 |
|
13 |
13 |
$117.00 |
| 90734 |
|
24 |
12 |
$108.00 |
| 85018 |
|
373 |
195 |
$43.70 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
12 |
$5.35 |
| 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 |
2,160 |
1,930 |
$0.00 |
| 99173 |
|
851 |
848 |
$0.00 |