| 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 |
8,095 |
6,580 |
$4.33M |
| 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 |
6,693 |
3,506 |
$3.83M |
| D0140 |
Limited oral evaluation - problem focused |
249 |
237 |
$86K |
| D0120 |
Periodic oral evaluation - established patient |
473 |
473 |
$40K |
| D1206 |
Topical application of fluoride varnish |
1,198 |
1,165 |
$18K |
| D1351 |
Sealant - per tooth |
984 |
127 |
$15K |
| 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 |
44 |
43 |
$10K |
| D1120 |
Prophylaxis - child |
260 |
260 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
73 |
73 |
$7K |
| D1110 |
Prophylaxis - adult |
25 |
25 |
$7K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,975 |
1,357 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,284 |
5,171 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
209 |
206 |
$3K |
| D0191 |
|
133 |
130 |
$3K |
| D0274 |
Bitewings - four radiographic images |
83 |
83 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
183 |
180 |
$1K |
| 99402 |
|
12 |
12 |
$902.68 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
30 |
30 |
$890.19 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
966 |
908 |
$791.65 |
| 90832 |
Psychotherapy, 30 minutes with patient |
281 |
226 |
$470.53 |
| 90834 |
Psychotherapy, 45 minutes with patient |
876 |
694 |
$313.80 |
| D1310 |
|
588 |
577 |
$0.00 |
| D1330 |
|
39 |
39 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
209 |
204 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
74 |
73 |
$0.00 |