| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,288 |
2,082 |
$397K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
298 |
269 |
$50K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
85 |
80 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
49 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
39 |
$9K |
| Q3014 |
Telehealth originating site facility fee |
186 |
148 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
85 |
77 |
$773.96 |
| 90461 |
|
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
28 |
26 |
$0.00 |
| 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 |
187 |
156 |
$0.00 |