| 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 |
8,635 |
7,382 |
$565K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
190 |
189 |
$146K |
| 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 |
501 |
494 |
$33K |
| 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 |
278 |
260 |
$18K |
| 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 |
228 |
225 |
$16K |
| D7140 |
Extraction, erupted tooth or exposed root |
382 |
226 |
$13K |
| D1110 |
Prophylaxis - adult |
437 |
436 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
535 |
534 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
324 |
322 |
$8K |
| D0210 |
Intraoral - complete series of radiographic images |
219 |
218 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,850 |
4,351 |
$6K |
| D0274 |
Bitewings - four radiographic images |
151 |
151 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
174 |
172 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
334 |
329 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,484 |
1,404 |
$2K |
| 90651 |
|
14 |
14 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
549 |
532 |
$340.97 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
48 |
48 |
$275.46 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,049 |
976 |
$153.05 |
| 90688 |
|
148 |
148 |
$137.30 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
329 |
323 |
$98.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
24 |
24 |
$70.46 |
| 99000 |
|
28 |
28 |
$52.50 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
51 |
49 |
$49.33 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
64 |
63 |
$46.95 |
| 90832 |
Psychotherapy, 30 minutes with patient |
150 |
138 |
$39.03 |
| 81025 |
|
57 |
56 |
$14.26 |
| 81002 |
|
243 |
237 |
$10.61 |
| 82962 |
|
81 |
76 |
$10.55 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
56 |
55 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
52 |
52 |
$0.00 |
| 1160F |
|
54 |
51 |
$0.00 |
| 3078F |
|
668 |
612 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
68 |
68 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$0.00 |
| 90461 |
|
262 |
251 |
$0.00 |
| 3077F |
|
331 |
306 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90670 |
|
30 |
30 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
45 |
42 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
12 |
12 |
$0.00 |
| 1159F |
|
53 |
50 |
$0.00 |
| 3074F |
|
1,144 |
1,037 |
$0.00 |
| 3044F |
|
228 |
200 |
$0.00 |
| 3080F |
|
359 |
331 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
59 |
58 |
$0.00 |
| 3079F |
|
661 |
623 |
$0.00 |
| 3048F |
|
31 |
26 |
$0.00 |
| 3075F |
|
223 |
214 |
$0.00 |
| 3008F |
|
1,662 |
1,462 |
$0.00 |
| 1126F |
|
23 |
22 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
16 |
16 |
$0.00 |
| 3049F |
|
15 |
14 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
14 |
12 |
$0.00 |
| 1036F |
|
37 |
35 |
$0.00 |
| 90698 |
|
25 |
25 |
$0.00 |
| 90632 |
|
15 |
15 |
$0.00 |
| 90686 |
|
29 |
29 |
$0.00 |
| 1125F |
|
14 |
14 |
$0.00 |