| 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 |
132,671 |
93,329 |
$9.61M |
| 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 |
30,056 |
21,076 |
$2.05M |
| D7140 |
Extraction, erupted tooth or exposed root |
19,851 |
10,172 |
$1.67M |
| D0140 |
Limited oral evaluation - problem focused |
19,279 |
18,673 |
$1.52M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
9,067 |
7,033 |
$1.16M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
10,521 |
10,464 |
$742K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
6,247 |
4,576 |
$647K |
| D1110 |
Prophylaxis - adult |
8,972 |
8,906 |
$617K |
| 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 |
6,658 |
6,514 |
$560K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,240 |
3,241 |
$549K |
| D0120 |
Periodic oral evaluation - established patient |
9,461 |
9,402 |
$534K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
3,281 |
2,929 |
$466K |
| D1120 |
Prophylaxis - child |
9,161 |
9,127 |
$369K |
| G0469 |
Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health 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 mental health visit |
4,186 |
4,112 |
$304K |
| D4355 |
|
2,364 |
2,327 |
$280K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
47,498 |
41,001 |
$277K |
| D1206 |
Topical application of fluoride varnish |
10,792 |
10,750 |
$273K |
| D0210 |
Intraoral - complete series of radiographic images |
6,881 |
6,767 |
$251K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43,751 |
39,117 |
$214K |
| D1351 |
Sealant - per tooth |
7,548 |
1,836 |
$213K |
| D0220 |
Intraoral - periapical first radiographic image |
17,216 |
16,777 |
$207K |
| D0274 |
Bitewings - four radiographic images |
8,637 |
8,582 |
$203K |
| D2331 |
|
1,615 |
1,277 |
$173K |
| D2335 |
|
876 |
724 |
$116K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,348 |
1,340 |
$105K |
| D2330 |
|
1,116 |
842 |
$104K |
| D0330 |
Panoramic radiographic image |
2,478 |
2,465 |
$85K |
| D2332 |
|
734 |
597 |
$82K |
| D0191 |
|
3,780 |
3,747 |
$77K |
| D0230 |
Intraoral - periapical each additional radiographic image |
9,607 |
5,560 |
$72K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
17,613 |
4,767 |
$61K |
| H0031 |
Mental health assessment, by non-physician |
5,849 |
5,707 |
$51K |
| D0272 |
Bitewings - two radiographic images |
2,385 |
2,373 |
$50K |
| 90837 |
Psychotherapy, 53 minutes with patient |
6,192 |
3,496 |
$41K |
| 90651 |
|
2,075 |
2,063 |
$40K |
| D2394 |
|
242 |
226 |
$38K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
10,036 |
3,348 |
$38K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,553 |
3,533 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,793 |
3,779 |
$32K |
| D0270 |
|
2,591 |
2,549 |
$30K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
13,928 |
12,262 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,867 |
2,849 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,846 |
2,810 |
$23K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,515 |
2,611 |
$20K |
| D5110 |
|
40 |
40 |
$20K |
| D7230 |
|
79 |
54 |
$17K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
89 |
80 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,116 |
4,103 |
$16K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,540 |
1,520 |
$12K |
| D0145 |
Oral evaluation for a patient under three years of age |
396 |
395 |
$11K |
| 97161 |
|
1,452 |
1,440 |
$11K |
| 99215 |
Prolong outpt/office vis |
1,254 |
1,228 |
$11K |
| D4346 |
|
127 |
127 |
$10K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
2,790 |
1,424 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,466 |
1,436 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,736 |
8,647 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,122 |
4,083 |
$9K |
| D5120 |
|
12 |
12 |
$9K |
| D3320 |
|
26 |
25 |
$8K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,043 |
1,564 |
$8K |
| 90791 |
Psychiatric diagnostic evaluation |
927 |
908 |
$8K |
| 90480 |
|
250 |
250 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,399 |
2,353 |
$7K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
592 |
589 |
$6K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
291 |
289 |
$6K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,902 |
1,225 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,796 |
3,572 |
$6K |
| 90670 |
|
2,484 |
2,477 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,096 |
1,078 |
$4K |
| 90686 |
|
4,764 |
4,738 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
489 |
477 |
$4K |
| 91320 |
|
182 |
182 |
$4K |
| 90677 |
|
501 |
501 |
$3K |
| D2950 |
|
19 |
17 |
$3K |
| 81025 |
|
3,199 |
3,130 |
$3K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
24 |
24 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,397 |
1,373 |
$3K |
| D4341 |
|
17 |
12 |
$2K |
| 99442 |
|
284 |
265 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,531 |
2,496 |
$2K |
| 97014 |
|
1,394 |
594 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
967 |
954 |
$2K |
| 90715 |
|
1,436 |
1,429 |
$2K |
| 97035 |
|
1,588 |
689 |
$2K |
| 81002 |
|
4,258 |
4,119 |
$2K |
| 99406 |
|
13,249 |
11,156 |
$2K |
| D9930 |
|
12 |
12 |
$2K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
808 |
740 |
$1K |
| 97032 |
|
663 |
381 |
$1K |
| 90656 |
|
272 |
272 |
$1K |
| 99385 |
|
155 |
154 |
$1K |
| 90716 |
|
1,684 |
1,677 |
$919.40 |
| 82962 |
|
2,863 |
2,714 |
$910.55 |
| 83655 |
|
283 |
283 |
$819.11 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,325 |
1,048 |
$771.31 |
| 99381 |
|
148 |
148 |
$767.47 |
| 97162 |
|
44 |
44 |
$424.95 |
| 90620 |
|
199 |
199 |
$420.00 |
| 99386 |
|
51 |
51 |
$333.74 |
| 90474 |
|
672 |
644 |
$268.14 |
| 97168 |
|
25 |
25 |
$265.82 |
| 85018 |
|
1,224 |
1,220 |
$263.44 |
| 90707 |
|
1,630 |
1,621 |
$231.45 |
| D0190 |
|
14 |
14 |
$228.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
228 |
222 |
$221.88 |
| 97124 |
|
44 |
27 |
$202.08 |
| 99383 |
|
48 |
48 |
$202.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
20 |
15 |
$160.08 |
| 99443 |
|
40 |
29 |
$130.74 |
| D1354 |
|
14 |
12 |
$124.00 |
| 99402 |
|
24 |
24 |
$104.23 |
| 99384 |
|
48 |
48 |
$101.00 |
| 96127 |
|
275 |
275 |
$88.34 |
| 99441 |
|
88 |
83 |
$68.12 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
39 |
37 |
$63.00 |
| 99201 |
|
38 |
38 |
$47.27 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
90 |
90 |
$36.03 |
| 96160 |
|
224 |
198 |
$34.88 |
| 90647 |
|
2,128 |
2,126 |
$0.00 |
| 90680 |
|
27 |
27 |
$0.00 |
| 90723 |
|
1,575 |
1,573 |
$0.00 |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
388 |
329 |
$0.00 |
| D0601 |
|
39 |
36 |
$0.00 |
| D0603 |
|
312 |
308 |
$0.00 |
| 90619 |
|
716 |
715 |
$0.00 |
| 90696 |
|
354 |
352 |
$0.00 |
| 3074F |
|
4,943 |
4,532 |
$0.00 |
| 3075F |
|
744 |
711 |
$0.00 |
| 3079F |
|
1,415 |
1,350 |
$0.00 |
| 90732 |
|
34 |
34 |
$0.00 |
| 3080F |
|
431 |
410 |
$0.00 |
| D1310 |
|
332 |
325 |
$0.00 |
| 90697 |
|
43 |
43 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
55 |
55 |
$0.00 |
| 3044F |
|
161 |
159 |
$0.00 |
| D0602 |
|
217 |
216 |
$0.00 |
| D1330 |
|
753 |
738 |
$0.00 |
| 99051 |
|
11,809 |
11,339 |
$0.00 |
| 90461 |
|
2,200 |
2,196 |
$0.00 |
| 90633 |
|
1,712 |
1,709 |
$0.00 |
| 90713 |
|
430 |
428 |
$0.00 |
| 90700 |
|
1,288 |
1,282 |
$0.00 |
| 90734 |
|
946 |
941 |
$0.00 |
| 90681 |
|
915 |
914 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,248 |
1,202 |
$0.00 |
| 3078F |
|
4,397 |
4,074 |
$0.00 |
| 3077F |
|
538 |
507 |
$0.00 |
| 90685 |
|
286 |
285 |
$0.00 |
| 90710 |
|
61 |
61 |
$0.00 |
| 99173 |
|
16 |
15 |
$0.00 |
| 3046F |
|
18 |
18 |
$0.00 |
| 99382 |
|
13 |
13 |
$0.00 |
| 90746 |
|
13 |
13 |
$0.00 |