| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
24,257 |
21,935 |
$2.02M |
| 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 |
9,225 |
8,097 |
$319K |
| 0012A |
|
586 |
585 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,402 |
2,243 |
$23K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
911 |
898 |
$22K |
| 90677 |
|
334 |
334 |
$22K |
| 96127 |
|
2,489 |
1,977 |
$21K |
| 0011A |
|
407 |
407 |
$17K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
595 |
594 |
$14K |
| 90715 |
|
541 |
540 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,184 |
1,184 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,182 |
1,182 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
712 |
707 |
$10K |
| 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 |
641 |
641 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
598 |
593 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
701 |
662 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
878 |
877 |
$6K |
| 0002A |
|
112 |
112 |
$5K |
| 90686 |
|
671 |
670 |
$5K |
| 97803 |
|
92 |
88 |
$4K |
| 0001A |
|
81 |
81 |
$3K |
| 81025 |
|
443 |
438 |
$3K |
| 83037 |
|
342 |
339 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
410 |
404 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
686 |
683 |
$3K |
| 99381 |
|
13 |
13 |
$2K |
| 99050 |
|
133 |
130 |
$2K |
| 90707 |
|
154 |
153 |
$2K |
| 90656 |
|
66 |
66 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
77 |
66 |
$906.14 |
| 0031A |
|
19 |
19 |
$871.53 |
| 81002 |
|
290 |
284 |
$863.65 |
| 90651 |
|
49 |
48 |
$700.00 |
| 90649 |
|
114 |
114 |
$687.95 |
| A0425 |
Ground mileage, per statute mile |
28 |
28 |
$680.94 |
| 97802 |
|
13 |
13 |
$599.50 |
| 99443 |
|
19 |
17 |
$516.63 |
| 90688 |
|
28 |
28 |
$460.08 |
| 87210 |
|
81 |
81 |
$410.40 |
| 86580 |
|
60 |
58 |
$362.40 |
| 90716 |
|
122 |
120 |
$300.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13 |
12 |
$234.60 |
| 82948 |
|
44 |
39 |
$120.98 |
| 90670 |
|
85 |
84 |
$100.00 |
| 90633 |
|
346 |
346 |
$50.00 |
| 90648 |
|
443 |
441 |
$0.00 |
| 91300 |
|
636 |
571 |
$0.00 |
| 90671 |
|
178 |
178 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
339 |
331 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$0.00 |
| 90710 |
|
72 |
72 |
$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 |
15 |
15 |
$0.00 |
| 99051 |
|
18 |
18 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 90723 |
|
337 |
336 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,206 |
4,951 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,381 |
3,010 |
$0.00 |
| 91303 |
|
33 |
32 |
$0.00 |
| 91305 |
|
16 |
14 |
$0.00 |
| 91301 |
|
1,995 |
1,961 |
$0.00 |
| 92558 |
|
1,286 |
1,261 |
$0.00 |
| 90680 |
|
402 |
401 |
$0.00 |
| 90619 |
|
55 |
55 |
$0.00 |
| 90696 |
|
50 |
50 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
13 |
$0.00 |
| 90697 |
|
67 |
67 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
15 |
15 |
$0.00 |