| 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 |
22,459 |
19,157 |
$1.56M |
| J2315 |
Injection, naltrexone, depot form, 1 mg |
1,284 |
1,044 |
$1.27M |
| 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 |
8,086 |
4,205 |
$703K |
| 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 |
2,486 |
2,427 |
$181K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,539 |
10,408 |
$61K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,383 |
6,803 |
$55K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
458 |
458 |
$24K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,734 |
2,286 |
$23K |
| D0210 |
Intraoral - complete series of radiographic images |
296 |
295 |
$17K |
| D1110 |
Prophylaxis - adult |
241 |
241 |
$14K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,372 |
1,619 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
163 |
160 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,433 |
1,244 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
39 |
31 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
550 |
520 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,914 |
1,500 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
30 |
25 |
$3K |
| 80305 |
|
2,645 |
2,112 |
$3K |
| 90674 |
|
447 |
439 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
151 |
148 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
274 |
270 |
$2K |
| 96127 |
|
4,359 |
4,269 |
$2K |
| D0330 |
Panoramic radiographic image |
40 |
40 |
$2K |
| 0064A |
|
91 |
91 |
$2K |
| D4355 |
|
15 |
15 |
$2K |
| 90832 |
Psychotherapy, 30 minutes with patient |
850 |
549 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
21 |
12 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
884 |
873 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,673 |
1,518 |
$1K |
| 81025 |
|
1,105 |
908 |
$1K |
| 0011A |
|
56 |
56 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
42 |
42 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
545 |
521 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
71 |
71 |
$1K |
| 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 |
16 |
14 |
$839.50 |
| D0274 |
Bitewings - four radiographic images |
40 |
40 |
$707.26 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$707.00 |
| 90661 |
|
20 |
20 |
$626.45 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$545.46 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
307 |
300 |
$537.88 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
98 |
97 |
$532.78 |
| 81003 |
|
1,238 |
1,183 |
$510.64 |
| 0012A |
|
15 |
15 |
$376.36 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
106 |
103 |
$366.60 |
| 90686 |
|
44 |
41 |
$228.36 |
| 0134A |
|
12 |
12 |
$228.28 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
219 |
188 |
$194.91 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$162.84 |
| 99000 |
|
226 |
202 |
$129.37 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
73 |
68 |
$126.00 |
| 90791 |
Psychiatric diagnostic evaluation |
40 |
40 |
$102.42 |
| 82075 |
|
493 |
401 |
$99.00 |
| 81002 |
|
128 |
122 |
$95.04 |
| D0603 |
|
170 |
170 |
$95.00 |
| 90715 |
|
14 |
14 |
$65.70 |
| 93000 |
|
13 |
13 |
$47.55 |
| 99406 |
|
13 |
12 |
$25.56 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$21.00 |
| 82962 |
|
12 |
12 |
$2.71 |
| 3085F |
|
214 |
213 |
$0.00 |
| 2028F |
|
27 |
27 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
12 |
12 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
28 |
12 |
$0.00 |
| 36416 |
|
113 |
103 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,504 |
1,454 |
$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 |
12 |
$0.00 |
| 3044F |
|
18 |
18 |
$0.00 |
| 99385 |
|
15 |
15 |
$0.00 |