| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
12,146 |
8,799 |
$943K |
| 99214 |
|
6,713 |
5,170 |
$4K |
| 99213 |
|
2,788 |
2,243 |
$2K |
| 99215 |
Prolong outpt/office vis |
3,158 |
2,694 |
$983.90 |
| 99202 |
|
18 |
12 |
$36.00 |
| 87804 |
|
32 |
29 |
$33.36 |
| 87426 |
|
39 |
32 |
$31.02 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
546 |
422 |
$0.16 |
| 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 |
538 |
531 |
$0.00 |
| 3077F |
|
23 |
19 |
$0.00 |
| 99212 |
|
51 |
37 |
$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 |
63 |
54 |
$0.00 |
| 99490 |
Ccm add 20min |
77 |
68 |
$0.00 |
| 3078F |
|
68 |
57 |
$0.00 |
| 87400 |
|
20 |
18 |
$0.00 |
| 81002 |
|
15 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
191 |
140 |
$0.00 |
| 3074F |
|
59 |
49 |
$0.00 |
| 3079F |
|
20 |
19 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
57 |
44 |
$0.00 |
| 3080F |
|
19 |
14 |
$0.00 |