| 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 |
60,088 |
51,034 |
$4.09M |
| 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 |
28,973 |
18,957 |
$2.06M |
| D0140 |
Limited oral evaluation - problem focused |
7,411 |
7,273 |
$784K |
| D7140 |
Extraction, erupted tooth or exposed root |
5,467 |
3,129 |
$592K |
| D1110 |
Prophylaxis - adult |
5,905 |
5,874 |
$493K |
| D0120 |
Periodic oral evaluation - established patient |
4,051 |
4,037 |
$364K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
1,544 |
1,212 |
$344K |
| 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 |
3,813 |
3,793 |
$291K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,051 |
3,041 |
$277K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,357 |
1,684 |
$248K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,216 |
1,028 |
$164K |
| 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 |
1,978 |
1,941 |
$142K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
2,812 |
2,108 |
$136K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
44,293 |
38,356 |
$128K |
| D2140 |
|
896 |
690 |
$103K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
787 |
657 |
$100K |
| D0210 |
Intraoral - complete series of radiographic images |
2,786 |
2,747 |
$78K |
| D2331 |
|
658 |
496 |
$78K |
| D2332 |
|
569 |
410 |
$74K |
| D2160 |
|
521 |
478 |
$74K |
| D0220 |
Intraoral - periapical first radiographic image |
9,978 |
9,756 |
$62K |
| D2330 |
|
583 |
433 |
$61K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
315 |
249 |
$45K |
| D0274 |
Bitewings - four radiographic images |
2,778 |
2,765 |
$41K |
| D1120 |
Prophylaxis - child |
1,021 |
1,020 |
$38K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,293 |
1,289 |
$27K |
| D5110 |
|
24 |
24 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,243 |
7,776 |
$20K |
| 59426 |
|
26 |
26 |
$19K |
| D2335 |
|
119 |
100 |
$16K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,068 |
3,443 |
$16K |
| 90834 |
Psychotherapy, 45 minutes with patient |
8,466 |
6,481 |
$16K |
| 90832 |
Psychotherapy, 30 minutes with patient |
14,900 |
10,273 |
$15K |
| D4355 |
|
77 |
74 |
$11K |
| T1015 |
Clinic visit/encounter, all-inclusive |
172 |
129 |
$11K |
| 90791 |
Psychiatric diagnostic evaluation |
2,113 |
2,098 |
$10K |
| D0272 |
Bitewings - two radiographic images |
533 |
533 |
$9K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,336 |
1,829 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,546 |
1,539 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,588 |
2,467 |
$5K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
857 |
762 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,066 |
3,810 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,145 |
1,137 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
910 |
908 |
$3K |
| 90651 |
|
111 |
106 |
$2K |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
187 |
184 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
336 |
325 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
13 |
12 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,772 |
1,761 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
291 |
278 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
499 |
496 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
440 |
421 |
$1K |
| 90688 |
|
727 |
721 |
$867.52 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
495 |
493 |
$866.70 |
| 82274 |
|
303 |
301 |
$691.36 |
| 90658 |
|
50 |
50 |
$680.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
143 |
142 |
$644.44 |
| 99385 |
|
107 |
105 |
$596.22 |
| 99215 |
Prolong outpt/office vis |
283 |
274 |
$568.54 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
152 |
142 |
$496.96 |
| 92250 |
|
372 |
369 |
$339.75 |
| 81025 |
|
390 |
386 |
$280.14 |
| 80305 |
|
2,864 |
2,603 |
$271.18 |
| 87430 |
|
582 |
577 |
$215.71 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
41 |
$190.00 |
| 99383 |
|
26 |
26 |
$182.92 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
100 |
99 |
$182.92 |
| 81002 |
|
1,304 |
1,273 |
$166.84 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,362 |
1,356 |
$154.59 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
363 |
361 |
$130.99 |
| 92015 |
Determination of refractive state |
60 |
60 |
$121.40 |
| 99386 |
|
12 |
12 |
$117.10 |
| 90632 |
|
12 |
12 |
$102.76 |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
562 |
141 |
$86.17 |
| 99406 |
|
349 |
336 |
$56.84 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
31 |
26 |
$54.52 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
47 |
47 |
$48.91 |
| 93000 |
|
38 |
38 |
$38.04 |
| 90686 |
|
59 |
59 |
$19.03 |
| 97014 |
|
256 |
81 |
$8.72 |
| 82962 |
|
13 |
12 |
$7.92 |
| 59430 |
|
14 |
13 |
$0.00 |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
212 |
59 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
14 |
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 |
55 |
46 |
$0.00 |
| 3008F |
|
39 |
39 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
12 |
12 |
$0.00 |
| 2028F |
|
491 |
490 |
$0.00 |
| 97161 |
|
12 |
12 |
$0.00 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
62 |
24 |
$0.00 |
| 90734 |
|
91 |
91 |
$0.00 |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
60 |
55 |
$0.00 |
| 0521F |
|
149 |
149 |
$0.00 |
| 90715 |
|
58 |
58 |
$0.00 |
| 90633 |
|
29 |
29 |
$0.00 |
| 99382 |
|
12 |
12 |
$0.00 |
| 99173 |
|
36 |
36 |
$0.00 |
| 92552 |
|
12 |
12 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |