| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
21,491 |
18,896 |
$1.69M |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,637 |
1,060 |
$292K |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
3,061 |
1,967 |
$228K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
1,647 |
1,638 |
$160K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,410 |
7,798 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,329 |
8,526 |
$17K |
| 90480 |
|
152 |
150 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
566 |
564 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,595 |
892 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
497 |
484 |
$2K |
| 91322 |
|
39 |
39 |
$2K |
| 0064A |
|
79 |
79 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
755 |
703 |
$1K |
| 0124A |
|
76 |
71 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
358 |
332 |
$1K |
| 90656 |
|
91 |
91 |
$983.40 |
| 0134A |
|
69 |
67 |
$969.36 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
151 |
151 |
$940.81 |
| 80305 |
|
1,762 |
1,552 |
$844.83 |
| 0054A |
|
25 |
25 |
$756.52 |
| 0004A |
|
23 |
22 |
$714.35 |
| 99349 |
|
591 |
563 |
$705.66 |
| 91320 |
|
29 |
28 |
$655.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,195 |
1,174 |
$638.21 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
108 |
108 |
$611.26 |
| 90791 |
Psychiatric diagnostic evaluation |
132 |
125 |
$564.01 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
325 |
322 |
$511.50 |
| 96127 |
|
1,580 |
1,478 |
$329.94 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
835 |
832 |
$233.16 |
| 90832 |
Psychotherapy, 30 minutes with patient |
130 |
111 |
$227.95 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
648 |
578 |
$165.28 |
| 90686 |
|
461 |
454 |
$155.62 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$145.58 |
| H2011 |
Crisis intervention service, per 15 minutes |
15 |
13 |
$100.50 |
| 81025 |
|
307 |
299 |
$92.69 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
94 |
92 |
$90.39 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
96 |
96 |
$81.34 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
28 |
28 |
$53.88 |
| 81002 |
|
236 |
234 |
$26.02 |
| 90688 |
|
139 |
137 |
$20.88 |
| 36415 |
Collection of venous blood by venipuncture |
280 |
270 |
$19.84 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
47 |
45 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
67 |
63 |
$0.00 |
| 3077F |
|
484 |
461 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| 80354 |
|
86 |
77 |
$0.00 |
| 83037 |
|
66 |
66 |
$0.00 |
| 99173 |
|
38 |
38 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 36416 |
|
1,231 |
1,217 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
66 |
66 |
$0.00 |
| 3080F |
|
426 |
412 |
$0.00 |
| 3075F |
|
335 |
330 |
$0.00 |
| 1111F |
|
57 |
55 |
$0.00 |
| 3044F |
|
73 |
70 |
$0.00 |
| 99406 |
|
40 |
39 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |