| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,551 |
5,215 |
$1.07M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,019 |
3,268 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
498 |
406 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
132 |
115 |
$972.44 |
| 90686 |
|
63 |
62 |
$872.44 |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
12 |
12 |
$612.00 |
| 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 |
347 |
255 |
$266.08 |
| 90656 |
|
13 |
13 |
$223.50 |
| 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 |
508 |
484 |
$63.36 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
121 |
114 |
$54.39 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
57 |
55 |
$20.80 |
| 3078F |
|
149 |
136 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
14 |
12 |
$0.00 |
| 3008F |
|
102 |
97 |
$0.00 |
| 3074F |
|
183 |
165 |
$0.00 |
| 3079F |
|
29 |
29 |
$0.00 |