| 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 |
19,460 |
17,068 |
$1.30M |
| 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 |
3,963 |
2,711 |
$281K |
| D0140 |
Limited oral evaluation - problem focused |
2,097 |
2,073 |
$206K |
| D1110 |
Prophylaxis - adult |
2,298 |
2,296 |
$195K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,155 |
681 |
$122K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
976 |
693 |
$93K |
| D0120 |
Periodic oral evaluation - established patient |
1,625 |
1,623 |
$82K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,204 |
1,204 |
$82K |
| 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 |
980 |
974 |
$76K |
| D1120 |
Prophylaxis - child |
1,127 |
1,125 |
$42K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
321 |
264 |
$40K |
| 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 |
523 |
507 |
$37K |
| D0220 |
Intraoral - periapical first radiographic image |
3,589 |
3,548 |
$36K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,943 |
12,365 |
$35K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,376 |
1,374 |
$30K |
| D0210 |
Intraoral - complete series of radiographic images |
720 |
719 |
$27K |
| D0274 |
Bitewings - four radiographic images |
897 |
896 |
$20K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,583 |
1,499 |
$11K |
| D0272 |
Bitewings - two radiographic images |
358 |
357 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,598 |
1,545 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,164 |
933 |
$3K |
| D2330 |
|
30 |
26 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,524 |
1,076 |
$3K |
| 80305 |
|
2,319 |
1,752 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
289 |
288 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,186 |
2,074 |
$2K |
| 90791 |
Psychiatric diagnostic evaluation |
226 |
224 |
$942.13 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
652 |
603 |
$936.85 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
31 |
$562.73 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
581 |
572 |
$474.80 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
81 |
81 |
$406.70 |
| 90688 |
|
266 |
264 |
$198.90 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
87 |
87 |
$193.74 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
86 |
86 |
$147.00 |
| 92552 |
|
12 |
12 |
$123.41 |
| 81002 |
|
124 |
122 |
$23.04 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
25 |
25 |
$0.00 |
| 92250 |
|
12 |
12 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
19 |
18 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
68 |
68 |
$0.00 |
| 2028F |
|
27 |
27 |
$0.00 |