| 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 |
40,433 |
21,895 |
$4.58M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31,887 |
24,034 |
$3.06M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24,062 |
19,674 |
$2.77M |
| 90832 |
Psychotherapy, 30 minutes with patient |
19,656 |
5,201 |
$1.70M |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
12,884 |
6,717 |
$1.26M |
| 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 |
3,698 |
1,117 |
$729K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,439 |
849 |
$347K |
| D4910 |
|
5,081 |
1,966 |
$347K |
| D0120 |
Periodic oral evaluation - established patient |
4,928 |
2,200 |
$327K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
5,418 |
1,444 |
$326K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,006 |
955 |
$235K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,707 |
3,572 |
$193K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,319 |
1,267 |
$162K |
| D4341 |
|
1,206 |
808 |
$144K |
| D1110 |
Prophylaxis - adult |
1,924 |
801 |
$117K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
3,993 |
3,601 |
$101K |
| 99215 |
Prolong outpt/office vis |
464 |
361 |
$66K |
| 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 |
144 |
144 |
$36K |
| D0140 |
Limited oral evaluation - problem focused |
300 |
151 |
$28K |
| D0210 |
Intraoral - complete series of radiographic images |
342 |
129 |
$24K |
| 90791 |
Psychiatric diagnostic evaluation |
68 |
68 |
$12K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
220 |
64 |
$9K |
| D9997 |
|
167 |
91 |
$8K |
| D1999 |
|
26 |
26 |
$6K |
| 99334 |
|
772 |
546 |
$6K |
| 11721 |
|
1,884 |
1,875 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
18 |
12 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
20 |
15 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
262 |
256 |
$2K |
| 96127 |
|
232 |
196 |
$934.32 |
| 0011A |
|
160 |
160 |
$779.70 |
| 11720 |
|
924 |
916 |
$768.00 |
| D0274 |
Bitewings - four radiographic images |
42 |
32 |
$722.88 |
| 0012A |
|
119 |
119 |
$633.86 |
| 0064A |
|
18 |
18 |
$630.88 |
| D0230 |
Intraoral - periapical each additional radiographic image |
94 |
90 |
$377.40 |
| 93000 |
|
144 |
144 |
$360.36 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
96 |
96 |
$246.76 |
| 90686 |
|
599 |
599 |
$96.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
983 |
983 |
$94.25 |
| G0008 |
Administration of influenza virus vaccine |
129 |
129 |
$13.23 |
| 1170F |
|
393 |
392 |
$0.00 |
| 1000F |
|
544 |
542 |
$0.00 |
| 90674 |
|
457 |
457 |
$0.00 |
| 3074F |
|
122 |
122 |
$0.00 |
| 1126F |
|
215 |
215 |
$0.00 |
| 1111F |
|
12 |
12 |
$0.00 |
| 99397 |
|
95 |
91 |
$0.00 |
| 1159F |
|
544 |
542 |
$0.00 |
| 3288F |
|
544 |
542 |
$0.00 |
| 1160F |
|
544 |
542 |
$0.00 |
| 99347 |
|
78 |
78 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
46 |
46 |
$0.00 |
| 3725F |
|
570 |
567 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
12 |
12 |
$0.00 |