| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
86,031 |
73,774 |
$13.92M |
| 00003 |
Internal/system code - not a standard HCPCS code |
59,834 |
32,277 |
$12.92M |
| 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 |
2,243 |
1,481 |
$106K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
276 |
236 |
$19K |
| 0012A |
|
40 |
40 |
$3K |
| 0011A |
|
26 |
26 |
$2K |
| 0001A |
|
27 |
27 |
$1K |
| 0002A |
|
15 |
15 |
$1K |
| 0064A |
|
13 |
13 |
$804.00 |
| 99173 |
|
626 |
626 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,114 |
1,113 |
$0.00 |
| 98940 |
|
713 |
474 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
644 |
640 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,391 |
6,053 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,047 |
1,028 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
309 |
307 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,090 |
1,087 |
$0.00 |
| 81025 |
|
95 |
94 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
139 |
139 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
654 |
653 |
$0.00 |
| 81003 |
|
739 |
618 |
$0.00 |
| Z6400 |
|
488 |
483 |
$0.00 |
| 90670 |
|
258 |
258 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
156 |
156 |
$0.00 |
| Z6200 |
|
26 |
26 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
135 |
105 |
$0.00 |
| 90681 |
|
88 |
88 |
$0.00 |
| 90633 |
|
90 |
90 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
113 |
113 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
107 |
107 |
$0.00 |
| Z6300 |
|
12 |
12 |
$0.00 |
| 11056 |
|
12 |
12 |
$0.00 |
| 11721 |
|
15 |
14 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26,902 |
25,077 |
$0.00 |
| 92551 |
|
653 |
652 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,944 |
5,743 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,734 |
1,724 |
$0.00 |
| 85018 |
|
1,146 |
1,146 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
834 |
656 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
45 |
45 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
155 |
154 |
$0.00 |
| Z1034 |
|
1,928 |
1,597 |
$0.00 |
| 90656 |
|
761 |
761 |
$0.00 |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
449 |
284 |
$0.00 |
| Z6204 |
|
27 |
27 |
$0.00 |
| 90686 |
|
86 |
86 |
$0.00 |
| 90474 |
|
103 |
103 |
$0.00 |
| Z1032 |
|
96 |
95 |
$0.00 |
| J3490 |
Unclassified drugs |
43 |
43 |
$0.00 |
| 90723 |
|
170 |
170 |
$0.00 |
| 90647 |
|
206 |
206 |
$0.00 |
| 90651 |
|
80 |
80 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
56 |
56 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |
| Z6404 |
|
27 |
26 |
$0.00 |
| Z6402 |
|
15 |
15 |
$0.00 |
| 99381 |
|
26 |
26 |
$0.00 |
| 99000 |
|
34 |
34 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
40 |
39 |
$0.00 |
| Z1038 |
|
15 |
15 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
25 |
25 |
$0.00 |
| Z6406 |
|
25 |
24 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |