| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
15,869 |
5,612 |
$1.06M |
| 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 |
30,615 |
11,455 |
$997K |
| D1110 |
Prophylaxis - adult |
8,159 |
3,291 |
$683K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,959 |
3,248 |
$618K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,740 |
1,813 |
$583K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,386 |
2,799 |
$518K |
| D0120 |
Periodic oral evaluation - established patient |
1,744 |
1,435 |
$277K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,841 |
913 |
$234K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,396 |
906 |
$228K |
| D0274 |
Bitewings - four radiographic images |
3,099 |
1,057 |
$167K |
| 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 |
3,254 |
825 |
$137K |
| D0140 |
Limited oral evaluation - problem focused |
1,411 |
688 |
$131K |
| D1999 |
|
803 |
463 |
$87K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,839 |
486 |
$68K |
| D4910 |
|
457 |
271 |
$65K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
260 |
141 |
$35K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
245 |
139 |
$30K |
| D1330 |
|
334 |
225 |
$26K |
| D4999 |
|
106 |
55 |
$12K |
| D7140 |
Extraction, erupted tooth or exposed root |
57 |
24 |
$5K |
| D0220 |
Intraoral - periapical first radiographic image |
420 |
316 |
$5K |
| 99397 |
|
20 |
12 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
34 |
12 |
$3K |
| D0230 |
Intraoral - periapical each additional radiographic image |
247 |
237 |
$2K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
18 |
12 |
$2K |
| 96127 |
|
39 |
12 |
$1K |