| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
5,329 |
4,444 |
$820K |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
2,096 |
1,302 |
$283K |
| 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 |
7,847 |
6,349 |
$278K |
| 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 |
728 |
635 |
$141K |
| 90834 |
Psychotherapy, 45 minutes with patient |
194 |
124 |
$17K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
933 |
736 |
$13K |
| 99382 |
|
32 |
32 |
$7K |
| 99383 |
|
27 |
27 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
667 |
646 |
$6K |
| 90832 |
Psychotherapy, 30 minutes with patient |
98 |
86 |
$4K |
| 99381 |
|
12 |
12 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
419 |
382 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
15 |
13 |
$2K |
| 99173 |
|
72 |
70 |
$2K |
| 90686 |
|
437 |
430 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
145 |
143 |
$1K |
| 99188 |
|
31 |
31 |
$806.00 |
| 90715 |
|
14 |
14 |
$460.04 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,470 |
3,144 |
$277.36 |
| 92551 |
|
29 |
27 |
$253.26 |
| 99442 |
|
13 |
13 |
$243.09 |
| 99441 |
|
12 |
12 |
$224.49 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$141.72 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,030 |
3,421 |
$19.65 |
| 99000 |
|
59 |
55 |
$0.00 |
| 36416 |
|
99 |
96 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
252 |
248 |
$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 |
38 |
36 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$0.00 |