| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
982 |
444 |
$71K |
| 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 |
851 |
699 |
$65K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
456 |
451 |
$45K |
| D1110 |
Prophylaxis - adult |
168 |
166 |
$16K |
| D0140 |
Limited oral evaluation - problem focused |
123 |
116 |
$13K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
39 |
26 |
$4K |
| D1206 |
Topical application of fluoride varnish |
376 |
374 |
$4K |
| 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 |
42 |
42 |
$3K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
16 |
12 |
$2K |
| D4355 |
|
15 |
15 |
$2K |
| D1120 |
Prophylaxis - child |
59 |
59 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
16 |
16 |
$827.91 |
| 90832 |
Psychotherapy, 30 minutes with patient |
197 |
101 |
$595.60 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
189 |
169 |
$483.93 |
| D0220 |
Intraoral - periapical first radiographic image |
191 |
169 |
$477.78 |
| D0274 |
Bitewings - four radiographic images |
34 |
32 |
$441.63 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$241.68 |
| D0210 |
Intraoral - complete series of radiographic images |
40 |
39 |
$220.02 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
41 |
39 |
$156.02 |
| 92591 |
|
14 |
14 |
$90.04 |
| 36415 |
Collection of venous blood by venipuncture |
33 |
33 |
$20.79 |
| 85018 |
|
30 |
30 |
$12.35 |
| 81000 |
|
25 |
24 |
$3.33 |
| D1330 |
|
128 |
124 |
$0.00 |