| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
2,864 |
2,564 |
$664K |
| 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 |
3,189 |
2,739 |
$75K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,236 |
1,039 |
$67K |
| 90834 |
Psychotherapy, 45 minutes with patient |
121 |
85 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,589 |
1,452 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,075 |
952 |
$9K |
| H2015 |
Comprehensive community support services, per 15 minutes |
62 |
38 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
331 |
302 |
$1K |
| 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 |
52 |
40 |
$658.07 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
14 |
13 |
$46.92 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$5.60 |
| D1110 |
Prophylaxis - adult |
115 |
115 |
$0.00 |
| 3078F |
|
198 |
189 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
39 |
39 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
65 |
64 |
$0.00 |
| 3077F |
|
13 |
12 |
$0.00 |
| D0330 |
Panoramic radiographic image |
16 |
16 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
41 |
41 |
$0.00 |
| 3074F |
|
110 |
100 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$0.00 |