| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
17,515 |
14,791 |
$2.45M |
| 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 |
3,567 |
3,081 |
$112K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
196 |
196 |
$30K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
772 |
748 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
178 |
178 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,024 |
1,012 |
$24K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
730 |
693 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
169 |
169 |
$19K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
642 |
475 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,275 |
1,268 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,173 |
1,150 |
$10K |
| 90686 |
|
715 |
713 |
$8K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
53 |
36 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
28 |
$5K |
| 90688 |
|
229 |
229 |
$2K |
| 0012A |
|
39 |
39 |
$2K |
| 90480 |
|
44 |
44 |
$2K |
| 99050 |
|
26 |
26 |
$1K |
| 96127 |
|
128 |
126 |
$1K |
| 81002 |
|
346 |
282 |
$926.23 |
| 90461 |
|
66 |
66 |
$826.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
38 |
$801.30 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
74 |
71 |
$789.86 |
| 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 |
23 |
12 |
$742.98 |
| 80305 |
|
76 |
64 |
$660.08 |
| 99188 |
|
12 |
12 |
$312.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,445 |
1,280 |
$199.12 |
| 90715 |
|
12 |
12 |
$197.16 |
| 81025 |
|
27 |
26 |
$169.52 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,718 |
1,612 |
$117.22 |
| 91322 |
|
13 |
13 |
$0.12 |
| 91301 |
|
282 |
280 |
$0.00 |
| 91306 |
|
92 |
92 |
$0.00 |
| 90674 |
|
71 |
71 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
87 |
87 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$0.00 |
| 91307 |
|
57 |
57 |
$0.00 |
| 91303 |
|
45 |
44 |
$0.00 |
| 90685 |
|
120 |
120 |
$0.00 |
| 91313 |
|
27 |
27 |
$0.00 |
| 91300 |
|
49 |
46 |
$0.00 |