| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
34,508 |
29,687 |
$2.45M |
| D7140 |
Extraction, erupted tooth or exposed root |
6,622 |
3,129 |
$519K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,012 |
4,986 |
$436K |
| D0140 |
Limited oral evaluation - problem focused |
3,963 |
3,907 |
$345K |
| D0120 |
Periodic oral evaluation - established patient |
5,176 |
5,154 |
$331K |
| 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 |
4,867 |
3,486 |
$316K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,411 |
1,854 |
$274K |
| D1110 |
Prophylaxis - adult |
4,249 |
4,225 |
$259K |
| 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 |
3,198 |
3,128 |
$251K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,411 |
1,794 |
$233K |
| 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 |
1,771 |
1,711 |
$121K |
| D0210 |
Intraoral - complete series of radiographic images |
4,300 |
4,273 |
$108K |
| D1120 |
Prophylaxis - child |
1,935 |
1,926 |
$75K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
591 |
488 |
$73K |
| D1206 |
Topical application of fluoride varnish |
2,260 |
2,250 |
$54K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,567 |
20,002 |
$53K |
| D0274 |
Bitewings - four radiographic images |
2,867 |
2,860 |
$47K |
| D4355 |
|
291 |
288 |
$32K |
| D0220 |
Intraoral - periapical first radiographic image |
3,620 |
3,582 |
$21K |
| D2330 |
|
173 |
133 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,155 |
3,865 |
$13K |
| D2331 |
|
109 |
85 |
$13K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
134 |
98 |
$11K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
109 |
88 |
$10K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,504 |
1,903 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
938 |
928 |
$9K |
| Q3014 |
Telehealth originating site facility fee |
624 |
594 |
$7K |
| D0190 |
|
1,601 |
1,596 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,099 |
1,086 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,425 |
1,406 |
$5K |
| D2332 |
|
54 |
36 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
852 |
815 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,308 |
2,257 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
710 |
709 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,042 |
3,960 |
$4K |
| H0031 |
Mental health assessment, by non-physician |
144 |
138 |
$3K |
| 80305 |
|
2,332 |
1,872 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
692 |
670 |
$2K |
| D0191 |
|
183 |
183 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,191 |
2,079 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
674 |
539 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
53 |
50 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,166 |
1,124 |
$2K |
| D2140 |
|
21 |
15 |
$1K |
| 81025 |
|
2,200 |
2,127 |
$1K |
| D1351 |
Sealant - per tooth |
55 |
16 |
$1K |
| 96127 |
|
6,116 |
5,413 |
$1K |
| 0012A |
|
29 |
29 |
$986.45 |
| D0272 |
Bitewings - two radiographic images |
56 |
55 |
$937.72 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,231 |
1,224 |
$937.72 |
| 99385 |
|
349 |
348 |
$894.33 |
| 0011A |
|
35 |
34 |
$872.74 |
| D0330 |
Panoramic radiographic image |
58 |
56 |
$870.84 |
| 90686 |
|
369 |
365 |
$851.12 |
| 99406 |
|
939 |
886 |
$826.15 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
115 |
114 |
$723.51 |
| 99384 |
|
24 |
24 |
$596.22 |
| 99383 |
|
38 |
38 |
$476.38 |
| 82962 |
|
1,472 |
1,423 |
$388.47 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
653 |
630 |
$310.25 |
| 92551 |
|
812 |
812 |
$304.86 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
17 |
16 |
$259.71 |
| 92558 |
|
142 |
142 |
$239.85 |
| 90715 |
|
30 |
30 |
$229.88 |
| 81002 |
|
734 |
715 |
$210.36 |
| 98960 |
|
41 |
38 |
$205.20 |
| 99215 |
Prolong outpt/office vis |
84 |
83 |
$104.79 |
| 99382 |
|
53 |
51 |
$101.00 |
| 99188 |
|
233 |
232 |
$83.36 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
46 |
46 |
$27.42 |
| 85018 |
|
12 |
12 |
$12.50 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
962 |
930 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
120 |
119 |
$0.00 |
| 3725F |
|
1,180 |
1,131 |
$0.00 |
| 4004F |
|
229 |
222 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
383 |
375 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
138 |
89 |
$0.00 |
| 99173 |
|
78 |
78 |
$0.00 |
| 90670 |
|
40 |
36 |
$0.00 |
| 97803 |
|
15 |
15 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
15 |
14 |
$0.00 |
| 3078F |
|
18 |
18 |
$0.00 |
| 3077F |
|
97 |
93 |
$0.00 |
| 4001F |
|
13 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,674 |
1,658 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
22 |
22 |
$0.00 |
| 3008F |
|
360 |
355 |
$0.00 |
| 3080F |
|
47 |
44 |
$0.00 |
| 99000 |
|
13 |
13 |
$0.00 |
| D1330 |
|
84 |
84 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |
| 3074F |
|
26 |
26 |
$0.00 |
| 3079F |
|
61 |
60 |
$0.00 |
| 3075F |
|
12 |
12 |
$0.00 |