| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
33,679 |
23,340 |
$2.75M |
| 98960 |
|
49 |
15 |
$2K |
| H2020 |
Therapeutic behavioral services, per diem |
24 |
12 |
$1K |
| 99051 |
|
118 |
80 |
$949.04 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
508 |
428 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
585 |
515 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
560 |
483 |
$0.00 |
| 3078F |
|
3,162 |
2,359 |
$0.00 |
| 1159F |
|
5,948 |
4,085 |
$0.00 |
| 1160F |
|
5,942 |
4,084 |
$0.00 |
| 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 |
1,975 |
1,885 |
$0.00 |
| 3077F |
|
1,171 |
893 |
$0.00 |
| 81002 |
|
531 |
415 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
22 |
13 |
$0.00 |
| 3725F |
|
388 |
339 |
$0.00 |
| 99173 |
|
47 |
38 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
241 |
216 |
$0.00 |
| 96160 |
|
126 |
60 |
$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 |
86 |
41 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
61 |
50 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
15 |
$0.00 |
| 1034F |
|
1,922 |
1,295 |
$0.00 |
| 3079F |
|
2,084 |
1,624 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27,228 |
19,673 |
$0.00 |
| 3008F |
|
4,547 |
3,263 |
$0.00 |
| 3075F |
|
1,010 |
844 |
$0.00 |
| 3074F |
|
4,103 |
2,983 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,406 |
2,822 |
$0.00 |
| 1036F |
|
5,756 |
3,807 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
31 |
25 |
$0.00 |
| 00000 |
|
657 |
264 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
430 |
319 |
$0.00 |
| 1035F |
|
155 |
122 |
$0.00 |
| 3080F |
|
974 |
769 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
313 |
127 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
86 |
52 |
$0.00 |
| 1126F |
|
295 |
248 |
$0.00 |
| 1125F |
|
12 |
12 |
$0.00 |