| 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 |
54,685 |
41,385 |
$1.97M |
| 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 |
7,625 |
7,623 |
$361K |
| D1110 |
Prophylaxis - adult |
688 |
678 |
$32K |
| 90677 |
|
320 |
320 |
$25K |
| G0008 |
Administration of influenza virus vaccine |
3,827 |
3,821 |
$17K |
| D0120 |
Periodic oral evaluation - established patient |
660 |
650 |
$13K |
| 90674 |
|
1,951 |
1,946 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,815 |
13,063 |
$5K |
| D0274 |
Bitewings - four radiographic images |
125 |
120 |
$4K |
| 90653 |
|
242 |
242 |
$3K |
| G0009 |
Administration of pneumococcal vaccine |
349 |
349 |
$3K |
| 90694 |
|
234 |
234 |
$2K |
| 90688 |
|
516 |
516 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
173 |
166 |
$2K |
| 90661 |
|
231 |
231 |
$1K |
| 90756 |
|
201 |
200 |
$890.85 |
| D0220 |
Intraoral - periapical first radiographic image |
61 |
60 |
$840.00 |
| 90732 |
|
25 |
25 |
$800.82 |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
12 |
$765.00 |
| 90686 |
|
160 |
160 |
$534.81 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
759 |
717 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
5,872 |
5,870 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
34,351 |
27,145 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
679 |
679 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
81 |
78 |
$0.00 |