| 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 |
65,157 |
57,621 |
$2.79M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27,358 |
25,492 |
$688K |
| D0140 |
Limited oral evaluation - problem focused |
4,764 |
4,606 |
$522K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30,358 |
28,009 |
$521K |
| D7140 |
Extraction, erupted tooth or exposed root |
4,573 |
3,318 |
$507K |
| D1110 |
Prophylaxis - adult |
6,661 |
6,625 |
$499K |
| 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 |
8,777 |
6,176 |
$438K |
| D1351 |
Sealant - per tooth |
14,610 |
3,980 |
$380K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,657 |
2,293 |
$372K |
| D1120 |
Prophylaxis - child |
9,599 |
9,582 |
$336K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,528 |
4,499 |
$334K |
| D0120 |
Periodic oral evaluation - established patient |
6,732 |
6,699 |
$299K |
| 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 |
3,887 |
3,846 |
$298K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,722 |
2,136 |
$286K |
| D1206 |
Topical application of fluoride varnish |
10,364 |
10,345 |
$230K |
| D0191 |
|
7,505 |
7,492 |
$133K |
| 99215 |
Prolong outpt/office vis |
2,359 |
2,254 |
$98K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,601 |
1,445 |
$92K |
| D0274 |
Bitewings - four radiographic images |
5,242 |
5,199 |
$90K |
| D0210 |
Intraoral - complete series of radiographic images |
1,797 |
1,678 |
$82K |
| D0220 |
Intraoral - periapical first radiographic image |
9,610 |
9,419 |
$81K |
| 90832 |
Psychotherapy, 30 minutes with patient |
4,136 |
3,581 |
$62K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
387 |
368 |
$58K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
319 |
301 |
$54K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,288 |
1,269 |
$54K |
| D0230 |
Intraoral - periapical each additional radiographic image |
11,891 |
5,823 |
$50K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,064 |
1,051 |
$32K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,414 |
1,406 |
$28K |
| D0272 |
Bitewings - two radiographic images |
1,349 |
1,345 |
$23K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
808 |
801 |
$22K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,380 |
4,304 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,874 |
1,799 |
$20K |
| 90686 |
|
2,571 |
2,545 |
$18K |
| D4355 |
|
218 |
217 |
$16K |
| 90632 |
|
533 |
531 |
$13K |
| D2331 |
|
89 |
78 |
$13K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,578 |
2,573 |
$10K |
| 0012A |
|
329 |
328 |
$10K |
| 90834 |
Psychotherapy, 45 minutes with patient |
437 |
351 |
$9K |
| 96160 |
|
1,008 |
997 |
$9K |
| 90746 |
|
308 |
306 |
$9K |
| 0011A |
|
330 |
330 |
$8K |
| 99385 |
|
332 |
328 |
$7K |
| D2335 |
|
42 |
40 |
$6K |
| D2330 |
|
45 |
30 |
$5K |
| D0270 |
|
825 |
814 |
$4K |
| 91322 |
|
91 |
89 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
917 |
908 |
$4K |
| 90670 |
|
29 |
29 |
$3K |
| 0013A |
|
104 |
89 |
$3K |
| 99001 |
|
336 |
335 |
$3K |
| 90651 |
|
25 |
25 |
$3K |
| 90739 |
|
24 |
24 |
$2K |
| 96156 |
|
108 |
105 |
$2K |
| 90715 |
|
135 |
134 |
$2K |
| 99408 |
|
240 |
237 |
$2K |
| 0134A |
|
63 |
63 |
$2K |
| 90656 |
|
78 |
78 |
$2K |
| 90480 |
|
71 |
70 |
$1K |
| 90750 |
|
13 |
13 |
$1K |
| 90732 |
|
31 |
30 |
$1K |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
92 |
82 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
47 |
47 |
$974.58 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
85 |
84 |
$794.99 |
| 99406 |
|
113 |
110 |
$689.85 |
| 81025 |
|
316 |
311 |
$653.49 |
| 0064A |
|
13 |
12 |
$381.12 |
| 96150 |
|
75 |
75 |
$324.24 |
| 99201 |
|
14 |
14 |
$204.40 |
| 81003 |
|
172 |
171 |
$161.14 |
| 92551 |
|
131 |
130 |
$141.23 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
32 |
30 |
$135.48 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
28 |
$128.40 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
630 |
434 |
$121.09 |
| 96158 |
|
12 |
12 |
$56.18 |
| G0008 |
Administration of influenza virus vaccine |
207 |
207 |
$1.35 |
| 99441 |
|
54 |
53 |
$0.00 |
| 91301 |
|
15 |
15 |
$0.00 |
| 99051 |
|
338 |
336 |
$0.00 |
| 99173 |
|
666 |
662 |
$0.00 |