| T1015 | Clinic visit/encounter, all-inclusive | 15 | 180 | 8,540 | $180 | $3M |
| T1013 | Sign language or oral interpretive services, per 15 minutes | 8 | 50 | 740 | $90 | $453.3K |
| 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… | 31 | 80 | 3,000 | $50 | $269.8K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 30 | 460 | 1,240 | $30 | $190K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 40 | 480 | 1,030 | $20 | $128.9K |
| 99392 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 40 | 70 | 1,060 | $40 | $97K |
| 99391 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 41 | 70 | 1,000 | $40 | $91K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 99 | 170 | 380 | $50 | $63.7K |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 24 | 80 | 540 | $40 | $61.6K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | 12 | 70 | 220 | $70 | $54K |