| 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 |
43,056 |
39,856 |
$2.98M |
| 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 |
4,972 |
4,948 |
$401K |
| 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 |
3,356 |
1,521 |
$231K |
| D0140 |
Limited oral evaluation - problem focused |
1,655 |
1,608 |
$142K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,457 |
1,456 |
$125K |
| D0120 |
Periodic oral evaluation - established patient |
2,173 |
2,167 |
$123K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
929 |
704 |
$115K |
| D1110 |
Prophylaxis - adult |
1,953 |
1,949 |
$113K |
| D7140 |
Extraction, erupted tooth or exposed root |
923 |
503 |
$91K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,941 |
18,848 |
$84K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
630 |
443 |
$62K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,595 |
10,253 |
$61K |
| D0210 |
Intraoral - complete series of radiographic images |
1,113 |
1,109 |
$32K |
| D1120 |
Prophylaxis - child |
722 |
722 |
$28K |
| D1206 |
Topical application of fluoride varnish |
948 |
948 |
$23K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
159 |
131 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,982 |
1,979 |
$21K |
| D0274 |
Bitewings - four radiographic images |
836 |
835 |
$20K |
| 59426 |
|
17 |
17 |
$18K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,197 |
1,075 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,891 |
1,861 |
$12K |
| D0220 |
Intraoral - periapical first radiographic image |
1,420 |
1,387 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,380 |
1,363 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,995 |
6,941 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,639 |
3,625 |
$8K |
| 90651 |
|
513 |
511 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,459 |
1,457 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,221 |
2,113 |
$7K |
| D2950 |
|
40 |
36 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
540 |
534 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
10,892 |
10,558 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
961 |
958 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
940 |
939 |
$5K |
| 90670 |
|
1,371 |
1,370 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
941 |
932 |
$4K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
26 |
18 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
414 |
207 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,745 |
2,718 |
$3K |
| 90686 |
|
2,378 |
2,363 |
$3K |
| 0012A |
|
130 |
130 |
$3K |
| 0011A |
|
140 |
140 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
332 |
329 |
$2K |
| 99385 |
|
253 |
253 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,281 |
1,184 |
$2K |
| 0002A |
|
58 |
58 |
$2K |
| 0001A |
|
55 |
55 |
$2K |
| 99406 |
|
926 |
894 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
129 |
129 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
356 |
355 |
$1K |
| 0064A |
|
35 |
35 |
$1K |
| 81025 |
|
998 |
969 |
$1K |
| 87634 |
|
180 |
178 |
$988.21 |
| 82962 |
|
2,063 |
2,018 |
$823.62 |
| 81002 |
|
1,979 |
1,920 |
$758.10 |
| 85018 |
|
2,738 |
2,730 |
$704.42 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
273 |
272 |
$697.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
225 |
223 |
$694.77 |
| 99381 |
|
66 |
66 |
$693.76 |
| 90656 |
|
117 |
117 |
$559.32 |
| D1354 |
|
46 |
12 |
$540.23 |
| 0071A |
|
14 |
14 |
$529.26 |
| 90715 |
|
274 |
273 |
$488.86 |
| 0072A |
|
12 |
12 |
$452.60 |
| 80305 |
|
130 |
127 |
$344.09 |
| 90619 |
|
109 |
109 |
$313.68 |
| 90677 |
|
138 |
138 |
$298.04 |
| 90632 |
|
23 |
23 |
$256.90 |
| 99383 |
|
25 |
25 |
$202.00 |
| 99384 |
|
51 |
51 |
$202.00 |
| 90474 |
|
299 |
298 |
$194.25 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
132 |
64 |
$191.94 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
87 |
84 |
$175.92 |
| 93000 |
|
109 |
108 |
$166.82 |
| 90621 |
|
90 |
90 |
$140.84 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
71 |
69 |
$114.50 |
| 81003 |
|
218 |
216 |
$85.61 |
| 71046 |
Radiologic examination, chest; 2 views |
13 |
13 |
$85.20 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$68.40 |
| 87807 |
|
18 |
18 |
$43.40 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
26 |
25 |
$33.91 |
| 92551 |
|
20 |
20 |
$19.62 |
| 83014 |
|
12 |
12 |
$7.23 |
| 0502F |
|
363 |
51 |
$0.19 |
| 3074F |
|
9,426 |
9,103 |
$0.03 |
| 0500F |
|
51 |
51 |
$0.02 |
| 3078F |
|
8,527 |
8,274 |
$0.00 |
| 3077F |
|
2,038 |
1,975 |
$0.00 |
| 3046F |
|
420 |
410 |
$0.00 |
| 90633 |
|
608 |
607 |
$0.00 |
| 90710 |
|
165 |
165 |
$0.00 |
| 90707 |
|
110 |
110 |
$0.00 |
| 3045F |
|
92 |
90 |
$0.00 |
| 90734 |
|
218 |
217 |
$0.00 |
| 90681 |
|
183 |
181 |
$0.00 |
| 91300 |
|
147 |
125 |
$0.00 |
| 3051F |
|
139 |
135 |
$0.00 |
| 90700 |
|
71 |
71 |
$0.00 |
| 99173 |
|
27 |
27 |
$0.00 |
| 90685 |
|
39 |
39 |
$0.00 |
| D0603 |
|
284 |
282 |
$0.00 |
| 3079F |
|
5,061 |
4,941 |
$0.00 |
| 3075F |
|
3,829 |
3,754 |
$0.00 |
| 3080F |
|
1,699 |
1,645 |
$0.00 |
| 3044F |
|
1,315 |
1,285 |
$0.00 |
| D1330 |
|
581 |
572 |
$0.00 |
| 36416 |
|
742 |
741 |
$0.00 |
| 90698 |
|
200 |
200 |
$0.00 |
| 90716 |
|
120 |
119 |
$0.00 |
| 90647 |
|
524 |
523 |
$0.00 |
| 91306 |
|
35 |
35 |
$0.00 |
| 90620 |
|
55 |
55 |
$0.00 |
| 90723 |
|
161 |
161 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
59 |
58 |
$0.00 |
| 91307 |
|
29 |
29 |
$0.00 |
| 99386 |
|
25 |
25 |
$0.00 |
| D0602 |
|
39 |
39 |
$0.00 |
| 91301 |
|
282 |
273 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
53 |
50 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90744 |
|
29 |
29 |
$0.00 |
| 90680 |
|
34 |
34 |
$0.00 |