| 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 |
8,916 |
7,115 |
$105.45 |
| D1110 |
Prophylaxis - adult |
2,518 |
2,472 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,435 |
2,376 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
1,077 |
1,048 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
807 |
774 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
539 |
510 |
$0.00 |
| 81003 |
|
1,782 |
1,678 |
$0.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
562 |
537 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
35 |
35 |
$0.00 |
| 90715 |
|
529 |
523 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
3,148 |
1,870 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
419 |
416 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
2,375 |
2,300 |
$0.00 |
| D4910 |
|
553 |
552 |
$0.00 |
| 81025 |
|
565 |
540 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
55 |
55 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
752 |
744 |
$0.00 |
| 80305 |
|
3,020 |
2,305 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
39 |
39 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
170 |
119 |
$0.00 |
| D0270 |
|
475 |
468 |
$0.00 |
| 82570 |
|
42 |
40 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,566 |
1,844 |
$0.00 |
| D4341 |
|
561 |
273 |
$0.00 |
| 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 |
109 |
68 |
$0.00 |
| D0330 |
Panoramic radiographic image |
263 |
262 |
$0.00 |
| 91322 |
|
89 |
89 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
244 |
235 |
$0.00 |
| 90682 |
|
711 |
695 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
390 |
385 |
$0.00 |
| 90756 |
|
12 |
12 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
147 |
115 |
$0.00 |
| 99408 |
|
13 |
13 |
$0.00 |
| 90661 |
|
50 |
50 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
13 |
12 |
$0.00 |
| D2940 |
|
14 |
14 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,572 |
1,452 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
11,296 |
10,510 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
2,252 |
2,188 |
$0.00 |
| 93000 |
|
108 |
107 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
1,184 |
1,169 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
2,935 |
2,810 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
1,823 |
1,806 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,344 |
2,309 |
$0.00 |
| 90674 |
|
599 |
593 |
$0.00 |
| 99606 |
|
955 |
797 |
$0.00 |
| 90686 |
|
298 |
291 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,947 |
1,929 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,452 |
10,494 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,305 |
1,290 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
2,134 |
1,021 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
668 |
525 |
$0.00 |
| 36416 |
|
3,729 |
3,310 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31,704 |
26,769 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
542 |
454 |
$0.00 |
| 99607 |
|
714 |
620 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
393 |
365 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
42 |
40 |
$0.00 |
| H0038 |
Self-help/peer services, per 15 minutes |
757 |
330 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
173 |
153 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
187 |
174 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
246 |
224 |
$0.00 |
| 87276 |
|
259 |
253 |
$0.00 |
| 90677 |
|
146 |
145 |
$0.00 |
| 94760 |
|
456 |
411 |
$0.00 |
| 90480 |
|
89 |
89 |
$0.00 |
| 87428 |
|
59 |
59 |
$0.00 |
| 82044 |
|
42 |
40 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
62 |
54 |
$0.00 |
| D2331 |
|
16 |
12 |
$0.00 |
| S9460 |
Diabetic management program, nurse visit |
17 |
13 |
$0.00 |
| 90732 |
|
15 |
15 |
$0.00 |