| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,638 |
26,248 |
$3.95M |
| 00003 |
Internal/system code - not a standard HCPCS code |
14,282 |
9,776 |
$2.66M |
| 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 |
493 |
358 |
$8K |
| 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 |
57 |
51 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,686 |
9,855 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
622 |
621 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
13 |
13 |
$2K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,148 |
860 |
$684.34 |
| 98940 |
|
2,060 |
1,454 |
$480.90 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
17 |
16 |
$373.52 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,705 |
1,578 |
$176.17 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,088 |
4,407 |
$141.52 |
| 90633 |
|
91 |
80 |
$9.00 |
| 90647 |
|
126 |
120 |
$0.00 |
| 92250 |
|
216 |
215 |
$0.00 |
| 90656 |
|
283 |
261 |
$0.00 |
| 90651 |
|
21 |
18 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
789 |
736 |
$0.00 |
| 92551 |
|
363 |
336 |
$0.00 |
| 90723 |
|
123 |
118 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
236 |
224 |
$0.00 |
| 90474 |
|
28 |
28 |
$0.00 |
| 90680 |
|
17 |
17 |
$0.00 |
| 99383 |
|
24 |
24 |
$0.00 |
| 90696 |
|
18 |
16 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
176 |
170 |
$0.00 |
| 92015 |
Determination of refractive state |
675 |
675 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
145 |
119 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
349 |
337 |
$0.00 |
| 11720 |
|
64 |
43 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
87 |
84 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
61 |
60 |
$0.00 |
| 11056 |
|
146 |
103 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
191 |
184 |
$0.00 |
| 99173 |
|
322 |
301 |
$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 |
51 |
47 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
38 |
35 |
$0.00 |
| 90670 |
|
195 |
187 |
$0.00 |
| 92133 |
|
12 |
12 |
$0.00 |
| 90681 |
|
14 |
13 |
$0.00 |
| 90700 |
|
13 |
12 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
20 |
17 |
$0.00 |