| 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 |
12,692 |
8,214 |
$1.85M |
| T1015 |
Clinic visit/encounter, all-inclusive |
4,925 |
4,060 |
$168K |
| 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 |
919 |
602 |
$125K |
| 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 |
96 |
60 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,216 |
3,532 |
$3K |
| D1110 |
Prophylaxis - adult |
45 |
39 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,539 |
3,098 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
26 |
26 |
$2K |
| D0330 |
Panoramic radiographic image |
13 |
13 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
13 |
13 |
$658.80 |
| D0220 |
Intraoral - periapical first radiographic image |
27 |
27 |
$607.56 |
| D0120 |
Periodic oral evaluation - established patient |
16 |
15 |
$606.34 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
13 |
$344.28 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
785 |
543 |
$214.50 |
| 99215 |
Prolong outpt/office vis |
279 |
164 |
$96.89 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
741 |
511 |
$96.70 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
79 |
55 |
$45.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
29 |
$26.01 |
| 81025 |
|
197 |
108 |
$17.07 |
| 99173 |
|
799 |
540 |
$16.03 |
| 82962 |
|
1,646 |
1,098 |
$8.65 |
| 81002 |
|
352 |
196 |
$0.15 |
| 90832 |
Psychotherapy, 30 minutes with patient |
16 |
12 |
$0.02 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
12 |
$0.01 |
| D1330 |
|
26 |
24 |
$0.00 |
| 0011A |
|
54 |
38 |
$0.00 |
| 91301 |
|
141 |
104 |
$0.00 |
| 0012A |
|
46 |
37 |
$0.00 |
| 92552 |
|
24 |
24 |
$0.00 |
| 99442 |
|
26 |
17 |
$0.00 |