| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
86,451 |
46,675 |
$11.09M |
| 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 |
13,354 |
10,030 |
$265K |
| 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 |
4,422 |
1,958 |
$121K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,572 |
1,521 |
$88K |
| 90834 |
Psychotherapy, 45 minutes with patient |
23,306 |
9,083 |
$48K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,210 |
29,033 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,751 |
9,495 |
$20K |
| 90832 |
Psychotherapy, 30 minutes with patient |
7,566 |
4,115 |
$9K |
| G0008 |
Administration of influenza virus vaccine |
1,326 |
1,078 |
$6K |
| 99442 |
|
422 |
359 |
$6K |
| 99443 |
|
253 |
196 |
$4K |
| 90677 |
|
12 |
12 |
$2K |
| 90686 |
|
1,079 |
849 |
$2K |
| 99441 |
|
209 |
172 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,018 |
1,706 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
243 |
177 |
$923.51 |
| 90791 |
Psychiatric diagnostic evaluation |
549 |
487 |
$551.30 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
798 |
685 |
$530.31 |
| G0009 |
Administration of pneumococcal vaccine |
59 |
56 |
$280.19 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,532 |
2,316 |
$268.94 |
| 90662 |
|
90 |
85 |
$235.17 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
386 |
363 |
$220.09 |
| 90715 |
|
399 |
316 |
$189.65 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
728 |
638 |
$189.65 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
419 |
358 |
$156.56 |
| 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 |
124 |
122 |
$113.74 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
882 |
776 |
$74.98 |
| 90837 |
Psychotherapy, 53 minutes with patient |
268 |
144 |
$62.74 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
616 |
529 |
$41.34 |
| 0124A |
|
34 |
29 |
$21.24 |
| 90688 |
|
103 |
89 |
$1.88 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,324 |
1,094 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
74 |
51 |
$0.00 |
| 99173 |
|
141 |
140 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
309 |
275 |
$0.00 |
| 4004F |
|
327 |
231 |
$0.00 |
| 90670 |
|
24 |
24 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
277 |
184 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
756 |
497 |
$0.00 |
| 99307 |
|
15 |
13 |
$0.00 |
| 91312 |
|
34 |
29 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
12 |
12 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
27 |
15 |
$0.00 |
| 91300 |
|
14 |
14 |
$0.00 |
| 99310 |
Prolong nursin fac eval 15m |
14 |
12 |
$0.00 |
| 36416 |
|
542 |
492 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
319 |
272 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
319 |
235 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
92 |
90 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
95 |
83 |
$0.00 |
| 87428 |
|
499 |
406 |
$0.00 |
| 90651 |
|
26 |
26 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$0.00 |
| 0064A |
|
17 |
13 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$0.00 |