| 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 |
25,058 |
21,952 |
$1.61M |
| 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 |
2,468 |
2,457 |
$176K |
| D7140 |
Extraction, erupted tooth or exposed root |
816 |
408 |
$86K |
| 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 |
1,435 |
713 |
$83K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,868 |
14,195 |
$66K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
567 |
567 |
$54K |
| D0140 |
Limited oral evaluation - problem focused |
520 |
514 |
$51K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
335 |
281 |
$44K |
| D1110 |
Prophylaxis - adult |
576 |
576 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,746 |
6,496 |
$40K |
| D0120 |
Periodic oral evaluation - established patient |
588 |
587 |
$35K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,008 |
525 |
$19K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
101 |
87 |
$14K |
| D0210 |
Intraoral - complete series of radiographic images |
420 |
420 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,530 |
1,522 |
$9K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
50 |
42 |
$6K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
663 |
650 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,057 |
1,024 |
$5K |
| D0274 |
Bitewings - four radiographic images |
197 |
197 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
8,837 |
8,535 |
$4K |
| 0064A |
|
85 |
85 |
$3K |
| 90632 |
|
396 |
395 |
$3K |
| 0012A |
|
119 |
119 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,086 |
1,055 |
$3K |
| 0011A |
|
122 |
122 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
61 |
61 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,511 |
2,467 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
330 |
329 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
1,049 |
1,029 |
$2K |
| 90686 |
|
1,107 |
1,097 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
176 |
176 |
$1K |
| 81025 |
|
1,434 |
1,387 |
$997.36 |
| D1120 |
Prophylaxis - child |
25 |
25 |
$960.31 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,382 |
1,366 |
$921.58 |
| 87634 |
|
114 |
114 |
$871.95 |
| 81002 |
|
3,057 |
2,951 |
$806.88 |
| 93000 |
|
821 |
813 |
$725.95 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
513 |
506 |
$673.03 |
| 90732 |
|
72 |
70 |
$672.63 |
| 90834 |
Psychotherapy, 45 minutes with patient |
135 |
64 |
$628.75 |
| D1206 |
Topical application of fluoride varnish |
27 |
27 |
$582.56 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
139 |
139 |
$532.78 |
| 90715 |
|
121 |
121 |
$517.22 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
234 |
233 |
$435.75 |
| 0031A |
|
14 |
14 |
$430.00 |
| 90656 |
|
41 |
41 |
$399.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
237 |
236 |
$393.59 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
196 |
97 |
$329.98 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
112 |
107 |
$314.74 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
76 |
75 |
$269.67 |
| 82962 |
|
1,258 |
1,193 |
$192.26 |
| 99406 |
|
105 |
105 |
$84.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
31 |
31 |
$83.15 |
| 82044 |
|
148 |
146 |
$77.40 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
41 |
41 |
$69.40 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
26 |
24 |
$52.10 |
| 81003 |
|
314 |
310 |
$35.53 |
| 96127 |
|
255 |
251 |
$32.78 |
| 85018 |
|
30 |
30 |
$3.92 |
| 3078F |
|
1,287 |
1,234 |
$0.00 |
| 91300 |
|
49 |
46 |
$0.00 |
| 3077F |
|
221 |
200 |
$0.00 |
| 3051F |
|
16 |
12 |
$0.00 |
| 3074F |
|
1,358 |
1,289 |
$0.00 |
| 3075F |
|
427 |
415 |
$0.00 |
| D1330 |
|
256 |
255 |
$0.00 |
| 3080F |
|
92 |
83 |
$0.00 |
| D0603 |
|
347 |
345 |
$0.00 |
| 3044F |
|
422 |
412 |
$0.00 |
| 3079F |
|
705 |
673 |
$0.00 |
| 91303 |
|
12 |
12 |
$0.00 |
| 91301 |
|
259 |
243 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
84 |
75 |
$0.00 |
| 91306 |
|
85 |
85 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
38 |
32 |
$0.00 |
| D0601 |
|
14 |
14 |
$0.00 |
| D0602 |
|
13 |
13 |
$0.00 |
| 1111F |
|
13 |
13 |
$0.00 |