| 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 |
76,345 |
67,512 |
$3.61M |
| 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 |
14,683 |
10,200 |
$687K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,249 |
25,749 |
$569K |
| 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 |
7,403 |
7,342 |
$546K |
| 59426 |
|
537 |
527 |
$504K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,643 |
11,859 |
$354K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
8,382 |
8,328 |
$327K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
9,351 |
9,191 |
$246K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,701 |
5,657 |
$219K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14,987 |
14,901 |
$161K |
| 90832 |
Psychotherapy, 30 minutes with patient |
8,098 |
7,072 |
$128K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,787 |
2,766 |
$112K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22,205 |
22,043 |
$111K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,440 |
1,457 |
$106K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16,031 |
15,913 |
$99K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,294 |
2,289 |
$95K |
| 99381 |
|
2,951 |
2,895 |
$82K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,279 |
2,262 |
$75K |
| D1120 |
Prophylaxis - child |
1,566 |
1,565 |
$62K |
| 90834 |
Psychotherapy, 45 minutes with patient |
2,510 |
1,781 |
$61K |
| 99215 |
Prolong outpt/office vis |
1,415 |
1,375 |
$54K |
| D1206 |
Topical application of fluoride varnish |
2,264 |
2,260 |
$51K |
| D0191 |
|
2,617 |
2,612 |
$36K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,666 |
2,570 |
$30K |
| 99383 |
|
926 |
925 |
$27K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
2,572 |
2,562 |
$26K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
608 |
608 |
$26K |
| 99382 |
|
858 |
856 |
$23K |
| D1110 |
Prophylaxis - adult |
284 |
282 |
$21K |
| 90651 |
|
2,628 |
2,620 |
$21K |
| 59430 |
|
268 |
263 |
$20K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,369 |
2,347 |
$13K |
| 81025 |
|
4,473 |
4,353 |
$12K |
| 90791 |
Psychiatric diagnostic evaluation |
252 |
238 |
$10K |
| D1351 |
Sealant - per tooth |
324 |
36 |
$8K |
| 59025 |
Fetal non-stress test |
1,022 |
576 |
$8K |
| 0002A |
|
223 |
220 |
$7K |
| 0001A |
|
268 |
261 |
$7K |
| 90474 |
|
1,950 |
1,941 |
$7K |
| D0190 |
|
1,075 |
1,073 |
$7K |
| 59425 |
|
15 |
14 |
$7K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$7K |
| 90715 |
|
1,929 |
1,926 |
$6K |
| 99384 |
|
219 |
218 |
$5K |
| 87210 |
|
2,566 |
2,468 |
$5K |
| 83655 |
|
1,099 |
1,096 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
279 |
278 |
$4K |
| 0071A |
|
67 |
63 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
228 |
224 |
$2K |
| 0072A |
|
49 |
43 |
$1K |
| 92551 |
|
572 |
570 |
$1K |
| 99385 |
|
56 |
56 |
$1K |
| 99188 |
|
311 |
310 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
92 |
90 |
$1K |
| 85018 |
|
1,344 |
1,339 |
$1K |
| D0274 |
Bitewings - four radiographic images |
42 |
41 |
$1K |
| 81003 |
|
1,223 |
1,200 |
$999.23 |
| 90480 |
|
57 |
57 |
$939.00 |
| 90686 |
|
8,212 |
8,183 |
$789.00 |
| 0003A |
|
30 |
30 |
$752.20 |
| D0120 |
Periodic oral evaluation - established patient |
28 |
28 |
$728.00 |
| 58300 |
|
25 |
25 |
$579.60 |
| 90656 |
|
488 |
488 |
$478.80 |
| 90670 |
|
6,297 |
6,261 |
$430.66 |
| 0012A |
|
17 |
16 |
$416.35 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$390.00 |
| 96380 |
|
32 |
32 |
$331.04 |
| 90473 |
|
83 |
83 |
$302.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
114 |
41 |
$294.00 |
| 58301 |
|
12 |
12 |
$267.45 |
| 90671 |
|
525 |
525 |
$211.00 |
| 96150 |
|
58 |
58 |
$197.16 |
| 96161 |
|
212 |
212 |
$140.38 |
| 90710 |
|
1,693 |
1,687 |
$133.75 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$68.45 |
| 90696 |
|
1,339 |
1,335 |
$41.25 |
| 0502F |
|
3,778 |
516 |
$0.06 |
| 90716 |
|
2,686 |
2,678 |
$0.00 |
| 90647 |
|
5,009 |
4,987 |
$0.00 |
| 90680 |
|
4,261 |
4,242 |
$0.00 |
| 90698 |
|
2,020 |
2,008 |
$0.00 |
| 90723 |
|
3,884 |
3,865 |
$0.00 |
| 90619 |
|
705 |
704 |
$0.00 |
| 0500F |
|
490 |
486 |
$0.00 |
| 90677 |
|
1,215 |
1,212 |
$0.00 |
| 90744 |
|
501 |
501 |
$0.00 |
| 90620 |
|
27 |
27 |
$0.00 |
| 91307 |
|
39 |
33 |
$0.00 |
| 90697 |
|
515 |
515 |
$0.00 |
| 90688 |
|
36 |
36 |
$0.00 |
| 88720 |
|
56 |
24 |
$0.00 |
| 90633 |
|
4,779 |
4,764 |
$0.00 |
| 90734 |
|
1,246 |
1,241 |
$0.00 |
| 90700 |
|
2,098 |
2,093 |
$0.00 |
| 90707 |
|
2,217 |
2,209 |
$0.00 |
| 90621 |
|
278 |
277 |
$0.00 |
| 90713 |
|
947 |
947 |
$0.00 |
| 99051 |
|
569 |
551 |
$0.00 |
| 99173 |
|
701 |
700 |
$0.00 |
| 90648 |
|
18 |
18 |
$0.00 |
| 90681 |
|
602 |
599 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |