| 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 |
116,318 |
99,191 |
$8.07M |
| 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 |
30,850 |
19,214 |
$2.22M |
| D1110 |
Prophylaxis - adult |
16,018 |
15,975 |
$1.67M |
| D0140 |
Limited oral evaluation - problem focused |
14,354 |
13,944 |
$1.51M |
| D7140 |
Extraction, erupted tooth or exposed root |
14,185 |
7,601 |
$1.39M |
| D0120 |
Periodic oral evaluation - established patient |
12,969 |
12,936 |
$1.01M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
5,688 |
4,734 |
$794K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
8,000 |
7,973 |
$726K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
5,948 |
4,760 |
$676K |
| 99402 |
|
8,847 |
8,019 |
$659K |
| 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 |
3,599 |
3,572 |
$297K |
| 59426 |
|
338 |
327 |
$288K |
| D5110 |
|
328 |
328 |
$282K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
1,723 |
1,607 |
$277K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,629 |
3,592 |
$268K |
| D1351 |
Sealant - per tooth |
9,808 |
2,322 |
$268K |
| D2331 |
|
1,869 |
1,541 |
$242K |
| D0274 |
Bitewings - four radiographic images |
10,318 |
10,290 |
$204K |
| D1120 |
Prophylaxis - child |
5,201 |
5,189 |
$202K |
| D1206 |
Topical application of fluoride varnish |
8,745 |
8,661 |
$188K |
| D2330 |
|
1,587 |
1,229 |
$181K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,385 |
1,121 |
$164K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
66,163 |
58,038 |
$156K |
| D0220 |
Intraoral - periapical first radiographic image |
16,575 |
16,102 |
$133K |
| D2335 |
|
764 |
668 |
$116K |
| D0210 |
Intraoral - complete series of radiographic images |
4,490 |
4,462 |
$105K |
| D2140 |
|
899 |
735 |
$90K |
| D0330 |
Panoramic radiographic image |
3,007 |
2,996 |
$74K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26,235 |
24,678 |
$72K |
| D2332 |
|
506 |
441 |
$70K |
| D0272 |
Bitewings - two radiographic images |
3,244 |
3,235 |
$63K |
| H1000 |
Prenatal care, at-risk assessment |
645 |
633 |
$54K |
| D5120 |
|
149 |
149 |
$51K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
313 |
285 |
$47K |
| 90832 |
Psychotherapy, 30 minutes with patient |
22,383 |
14,260 |
$43K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,894 |
4,781 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,782 |
4,747 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,631 |
3,608 |
$21K |
| 99000 |
|
2,137 |
2,066 |
$20K |
| 90651 |
|
1,709 |
1,694 |
$20K |
| 90791 |
Psychiatric diagnostic evaluation |
3,561 |
3,458 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,041 |
3,974 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
8,187 |
8,123 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16,619 |
16,437 |
$15K |
| D2394 |
|
83 |
78 |
$15K |
| D4355 |
|
99 |
99 |
$14K |
| D0145 |
Oral evaluation for a patient under three years of age |
463 |
462 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,336 |
2,322 |
$11K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
134 |
129 |
$11K |
| G9002 |
Coordinated care fee, maintenance rate |
979 |
828 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,352 |
2,334 |
$10K |
| 90480 |
|
426 |
426 |
$10K |
| 99499 |
|
129 |
116 |
$10K |
| 0002A |
|
294 |
294 |
$9K |
| D0270 |
|
1,171 |
1,161 |
$9K |
| 0031A |
|
283 |
283 |
$9K |
| 0001A |
|
345 |
345 |
$9K |
| 0124A |
|
528 |
528 |
$8K |
| 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 |
100 |
100 |
$8K |
| 0012A |
|
245 |
245 |
$8K |
| D2160 |
|
65 |
57 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
5,629 |
5,591 |
$8K |
| 90632 |
|
865 |
862 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,717 |
1,708 |
$8K |
| 99406 |
|
8,139 |
7,895 |
$7K |
| 98966 |
|
1,804 |
1,536 |
$7K |
| 81025 |
|
6,108 |
5,912 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
8,269 |
8,199 |
$7K |
| 0011A |
|
254 |
254 |
$6K |
| H2000 |
Comprehensive multidisciplinary evaluation |
60 |
59 |
$6K |
| 0064A |
|
233 |
233 |
$6K |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
8,273 |
8,217 |
$5K |
| 83655 |
|
2,539 |
2,482 |
$4K |
| 0071A |
|
170 |
170 |
$4K |
| 0072A |
|
123 |
123 |
$4K |
| 0054A |
|
177 |
177 |
$4K |
| 99381 |
|
873 |
857 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,457 |
1,420 |
$3K |
| 92551 |
|
7,443 |
7,400 |
$3K |
| 90746 |
|
466 |
465 |
$3K |
| 96156 |
|
1,688 |
1,609 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
660 |
532 |
$3K |
| 91322 |
|
73 |
73 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,433 |
4,297 |
$2K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,369 |
1,363 |
$2K |
| 90670 |
|
3,298 |
3,267 |
$2K |
| 0004A |
|
70 |
70 |
$2K |
| 90715 |
|
1,494 |
1,484 |
$2K |
| 81003 |
|
4,126 |
4,009 |
$2K |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
178 |
159 |
$2K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
191 |
157 |
$2K |
| 36416 |
|
10,085 |
9,778 |
$2K |
| 85018 |
|
2,899 |
2,850 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
65 |
63 |
$2K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
1,898 |
1,492 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
676 |
671 |
$1K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
819 |
744 |
$1K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,097 |
670 |
$1K |
| 87210 |
|
1,841 |
1,804 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
2,327 |
2,242 |
$1K |
| 0052A |
|
52 |
52 |
$1K |
| 99188 |
|
1,718 |
1,711 |
$1K |
| 59430 |
|
123 |
117 |
$1K |
| 98967 |
|
439 |
400 |
$1K |
| 82947 |
|
3,213 |
3,112 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
877 |
800 |
$935.89 |
| 0081A |
|
34 |
34 |
$831.18 |
| 90620 |
|
692 |
686 |
$808.20 |
| 91320 |
|
246 |
245 |
$786.60 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
435 |
435 |
$785.43 |
| 90714 |
|
418 |
418 |
$766.22 |
| 92588 |
|
403 |
396 |
$632.16 |
| 80061 |
Lipid panel |
1,061 |
1,049 |
$595.84 |
| 90677 |
|
158 |
157 |
$577.32 |
| 90473 |
|
1,434 |
1,415 |
$467.08 |
| 96150 |
|
263 |
243 |
$323.64 |
| 0051A |
|
14 |
14 |
$315.12 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$312.00 |
| 93000 |
|
261 |
256 |
$308.62 |
| 0034A |
|
13 |
13 |
$302.80 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
6,193 |
5,933 |
$301.75 |
| D1354 |
|
17 |
13 |
$276.86 |
| 98927 |
|
306 |
271 |
$274.63 |
| 90734 |
|
1,439 |
1,427 |
$252.88 |
| 0074A |
|
13 |
13 |
$211.07 |
| 99215 |
Prolong outpt/office vis |
57 |
55 |
$208.00 |
| 0154A |
|
14 |
14 |
$202.14 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
94 |
89 |
$202.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
19,846 |
18,827 |
$149.16 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
206 |
197 |
$148.16 |
| 90732 |
|
28 |
27 |
$139.18 |
| 90716 |
|
1,949 |
1,936 |
$136.26 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
218 |
215 |
$123.39 |
| 90707 |
|
1,992 |
1,978 |
$77.15 |
| 96151 |
|
76 |
68 |
$54.81 |
| 98926 |
|
58 |
53 |
$51.50 |
| 96160 |
|
314 |
305 |
$40.17 |
| G0008 |
Administration of influenza virus vaccine |
629 |
626 |
$14.41 |
| 90671 |
|
337 |
336 |
$0.08 |
| 94760 |
|
4,814 |
4,593 |
$0.00 |
| 90723 |
|
2,818 |
2,794 |
$0.00 |
| 90647 |
|
2,819 |
2,795 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
27 |
27 |
$0.00 |
| 94014 |
|
481 |
474 |
$0.00 |
| 90696 |
|
572 |
570 |
$0.00 |
| 90686 |
|
23 |
17 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
139 |
135 |
$0.00 |
| 90656 |
|
74 |
74 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |
| 91318 |
|
12 |
12 |
$0.00 |
| 99384 |
|
12 |
12 |
$0.00 |
| 90633 |
|
1,838 |
1,822 |
$0.00 |
| 91300 |
|
29 |
27 |
$0.00 |
| 90700 |
|
602 |
595 |
$0.00 |
| 90672 |
|
186 |
186 |
$0.00 |
| 90681 |
|
1,408 |
1,396 |
$0.00 |
| 98968 |
|
50 |
49 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
78 |
78 |
$0.00 |