| 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 |
21,733 |
18,954 |
$1.08M |
| 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 |
6,516 |
6,380 |
$350K |
| 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 |
5,238 |
3,613 |
$262K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,586 |
11,504 |
$143K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,971 |
4,805 |
$84K |
| 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 |
1,033 |
1,032 |
$58K |
| 90834 |
Psychotherapy, 45 minutes with patient |
3,011 |
2,325 |
$48K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
991 |
988 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,228 |
1,224 |
$27K |
| 90837 |
Psychotherapy, 53 minutes with patient |
526 |
445 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,431 |
2,212 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
813 |
771 |
$15K |
| 90832 |
Psychotherapy, 30 minutes with patient |
744 |
629 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,393 |
3,366 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
584 |
584 |
$12K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,631 |
1,625 |
$11K |
| 99215 |
Prolong outpt/office vis |
340 |
333 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
396 |
393 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,969 |
1,917 |
$8K |
| 90686 |
|
1,675 |
1,671 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
577 |
564 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
259 |
259 |
$5K |
| 0011A |
|
116 |
116 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
295 |
294 |
$3K |
| 0012A |
|
93 |
93 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
302 |
301 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
119 |
119 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
481 |
465 |
$2K |
| 92551 |
|
1,136 |
1,133 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
28 |
28 |
$2K |
| 0064A |
|
63 |
63 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
110 |
108 |
$2K |
| D1120 |
Prophylaxis - child |
42 |
42 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
321 |
321 |
$2K |
| D1206 |
Topical application of fluoride varnish |
52 |
50 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
32 |
32 |
$1K |
| 90677 |
|
57 |
57 |
$1K |
| 81025 |
|
370 |
364 |
$1K |
| 90656 |
|
103 |
103 |
$1K |
| 0134A |
|
45 |
44 |
$988.03 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
919 |
824 |
$850.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
89 |
83 |
$487.50 |
| 0094A |
|
13 |
13 |
$454.40 |
| 96160 |
|
768 |
767 |
$394.94 |
| 81002 |
|
440 |
423 |
$342.84 |
| 90670 |
|
499 |
499 |
$210.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
27 |
27 |
$194.96 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
25 |
25 |
$150.53 |
| 90836 |
|
14 |
14 |
$143.82 |
| 90473 |
|
25 |
25 |
$30.00 |
| 96127 |
|
13 |
13 |
$27.70 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
15 |
14 |
$8.71 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$6.84 |
| G9002 |
Coordinated care fee, maintenance rate |
299 |
278 |
$0.70 |
| 1220F |
|
5,739 |
4,894 |
$0.00 |
| 1036F |
|
3,135 |
3,035 |
$0.00 |
| 3079F |
|
2,402 |
2,314 |
$0.00 |
| 1034F |
|
855 |
830 |
$0.00 |
| 3075F |
|
1,048 |
1,025 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
1,033 |
1,026 |
$0.00 |
| 1000F |
|
4,550 |
4,411 |
$0.00 |
| 3080F |
|
122 |
118 |
$0.00 |
| 1125F |
|
608 |
592 |
$0.00 |
| 1126F |
|
1,076 |
1,056 |
$0.00 |
| 3074F |
|
7,474 |
7,004 |
$0.00 |
| 1031F |
|
165 |
162 |
$0.00 |
| 90723 |
|
173 |
173 |
$0.00 |
| 91301 |
|
254 |
254 |
$0.00 |
| 94760 |
|
79 |
79 |
$0.00 |
| 90697 |
|
25 |
25 |
$0.00 |
| 91306 |
|
23 |
23 |
$0.00 |
| 4010F |
|
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$0.00 |
| 1160F |
|
837 |
836 |
$0.00 |
| 1159F |
|
6,339 |
5,953 |
$0.00 |
| 3078F |
|
6,508 |
6,145 |
$0.00 |
| 3077F |
|
534 |
515 |
$0.00 |
| 3085F |
|
339 |
338 |
$0.00 |
| 90461 |
|
157 |
157 |
$0.00 |
| 1158F |
|
352 |
350 |
$0.00 |
| 90633 |
|
49 |
49 |
$0.00 |
| 90648 |
|
268 |
268 |
$0.00 |
| 91313 |
|
18 |
18 |
$0.00 |
| 4551F |
|
106 |
106 |
$0.00 |
| 2028F |
|
27 |
26 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |