| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
22,427 |
17,845 |
$3.47M |
| 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 |
538 |
422 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,211 |
7,664 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,144 |
1,080 |
$0.00 |
| 90686 |
|
302 |
302 |
$0.00 |
| 90656 |
|
137 |
137 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
241 |
238 |
$0.00 |
| 3079F |
|
60 |
60 |
$0.00 |
| Q3014 |
Telehealth originating site facility fee |
1,056 |
953 |
$0.00 |
| 85018 |
|
24 |
24 |
$0.00 |
| 85013 |
|
13 |
13 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
90 |
84 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
61 |
55 |
$0.00 |
| 3074F |
|
188 |
166 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
14 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
31 |
29 |
$0.00 |
| 3075F |
|
24 |
22 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,770 |
2,535 |
$0.00 |
| 92552 |
|
583 |
580 |
$0.00 |
| Z2702 |
|
308 |
308 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
244 |
221 |
$0.00 |
| 99173 |
|
304 |
304 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$0.00 |
| 82948 |
|
14 |
13 |
$0.00 |
| 81003 |
|
183 |
174 |
$0.00 |
| 90715 |
|
67 |
67 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
42 |
$0.00 |
| 3078F |
|
181 |
157 |
$0.00 |
| 3077F |
|
20 |
20 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$0.00 |
| 90658 |
|
12 |
12 |
$0.00 |