| 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 |
14,408 |
10,839 |
$5.35M |
| 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 |
8,925 |
4,605 |
$3.37M |
| D1110 |
Prophylaxis - adult |
2,280 |
2,276 |
$446K |
| 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 |
1,673 |
1,653 |
$443K |
| D0140 |
Limited oral evaluation - problem focused |
1,095 |
1,060 |
$318K |
| D0120 |
Periodic oral evaluation - established patient |
2,343 |
2,329 |
$287K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,157 |
1,155 |
$262K |
| 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 |
886 |
501 |
$198K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,098 |
437 |
$160K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
814 |
611 |
$152K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
752 |
542 |
$122K |
| 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 |
313 |
309 |
$89K |
| D1120 |
Prophylaxis - child |
1,490 |
1,485 |
$63K |
| D1206 |
Topical application of fluoride varnish |
3,244 |
3,222 |
$49K |
| D0330 |
Panoramic radiographic image |
1,206 |
1,187 |
$33K |
| D2740 |
Crown - porcelain/ceramic |
45 |
38 |
$30K |
| D0210 |
Intraoral - complete series of radiographic images |
858 |
824 |
$22K |
| D0274 |
Bitewings - four radiographic images |
669 |
669 |
$15K |
| D0220 |
Intraoral - periapical first radiographic image |
1,127 |
1,062 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,359 |
6,558 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,601 |
3,365 |
$8K |
| D2331 |
|
32 |
24 |
$6K |
| D0272 |
Bitewings - two radiographic images |
193 |
193 |
$4K |
| D2330 |
|
19 |
12 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,405 |
3,098 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,332 |
2,087 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
229 |
226 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
415 |
401 |
$2K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
932 |
549 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
330 |
134 |
$1K |
| D1351 |
Sealant - per tooth |
50 |
14 |
$1K |
| 0064A |
|
30 |
30 |
$847.85 |
| 90480 |
|
52 |
52 |
$809.74 |
| 0134A |
|
45 |
45 |
$793.17 |
| D0270 |
|
71 |
70 |
$592.51 |
| 0071A |
|
17 |
17 |
$533.55 |
| 0072A |
|
14 |
14 |
$435.70 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
669 |
664 |
$341.84 |
| 91322 |
|
48 |
48 |
$280.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$202.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
27 |
$195.72 |
| 90686 |
|
363 |
342 |
$186.08 |
| 36415 |
Collection of venous blood by venipuncture |
357 |
330 |
$142.24 |
| 99215 |
Prolong outpt/office vis |
112 |
109 |
$105.19 |
| 90791 |
Psychiatric diagnostic evaluation |
43 |
43 |
$102.42 |
| 98940 |
|
20 |
12 |
$100.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$100.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
189 |
96 |
$82.26 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
81 |
75 |
$82.02 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
12 |
$80.39 |
| G0008 |
Administration of influenza virus vaccine |
153 |
130 |
$42.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
112 |
110 |
$16.68 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$13.91 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
28 |
$13.69 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13 |
13 |
$12.86 |
| 80053 |
Comprehensive metabolic panel |
12 |
12 |
$8.74 |
| 81003 |
|
63 |
63 |
$0.00 |
| D0350 |
|
384 |
384 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
57 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
54 |
53 |
$0.00 |
| 90746 |
|
13 |
13 |
$0.00 |
| D1330 |
|
895 |
884 |
$0.00 |
| 97124 |
|
54 |
38 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
117 |
117 |
$0.00 |
| D3120 |
|
178 |
148 |
$0.00 |