| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
15,343 |
13,787 |
$2.91M |
| T1015 |
Clinic visit/encounter, all-inclusive |
12,952 |
11,250 |
$2.22M |
| T1040 |
Medicaid certified community behavioral health clinic services, per diem |
15,999 |
10,988 |
$2.21M |
| D9450 |
|
14,134 |
10,644 |
$402K |
| 90834 |
Psychotherapy, 45 minutes with patient |
4,681 |
3,550 |
$393K |
| 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 |
3,446 |
3,016 |
$114K |
| D1110 |
Prophylaxis - adult |
3,924 |
3,483 |
$75K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,326 |
1,192 |
$58K |
| D0140 |
Limited oral evaluation - problem focused |
2,164 |
1,379 |
$51K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,518 |
1,021 |
$46K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
253 |
253 |
$45K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,095 |
1,156 |
$42K |
| D0120 |
Periodic oral evaluation - established patient |
3,926 |
3,536 |
$38K |
| D0210 |
Intraoral - complete series of radiographic images |
1,294 |
1,163 |
$32K |
| D7140 |
Extraction, erupted tooth or exposed root |
588 |
228 |
$27K |
| D0220 |
Intraoral - periapical first radiographic image |
2,753 |
1,763 |
$26K |
| D0274 |
Bitewings - four radiographic images |
1,675 |
1,518 |
$24K |
| 90791 |
Psychiatric diagnostic evaluation |
133 |
133 |
$15K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
247 |
225 |
$12K |
| D2330 |
|
396 |
233 |
$11K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
28 |
25 |
$11K |
| D2331 |
|
246 |
169 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
760 |
678 |
$10K |
| D1206 |
Topical application of fluoride varnish |
395 |
389 |
$10K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
422 |
351 |
$10K |
| D1120 |
Prophylaxis - child |
138 |
138 |
$7K |
| D0330 |
Panoramic radiographic image |
130 |
100 |
$6K |
| 90688 |
|
448 |
448 |
$6K |
| 90686 |
|
557 |
556 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
655 |
351 |
$6K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
45 |
26 |
$6K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
17 |
15 |
$5K |
| D2335 |
|
51 |
41 |
$5K |
| 90750 |
|
58 |
58 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,254 |
3,974 |
$4K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
137 |
80 |
$4K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
18 |
17 |
$4K |
| D4341 |
|
100 |
24 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
501 |
394 |
$3K |
| 99173 |
|
148 |
147 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
450 |
449 |
$3K |
| D2332 |
|
41 |
26 |
$2K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
489 |
352 |
$2K |
| D0270 |
|
370 |
345 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,820 |
3,594 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
998 |
993 |
$2K |
| D0180 |
|
69 |
65 |
$2K |
| 90715 |
|
65 |
65 |
$2K |
| D4342 |
|
32 |
15 |
$1K |
| D2140 |
|
202 |
131 |
$1K |
| D2160 |
|
64 |
40 |
$1K |
| 81002 |
|
437 |
425 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
519 |
436 |
$1K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
35 |
34 |
$774.18 |
| 90461 |
|
47 |
47 |
$354.24 |
| D0272 |
Bitewings - two radiographic images |
16 |
13 |
$304.00 |
| A0425 |
Ground mileage, per statute mile |
35 |
31 |
$295.93 |
| 99442 |
|
102 |
90 |
$291.34 |
| 81025 |
|
44 |
43 |
$241.68 |
| 99441 |
|
105 |
91 |
$161.55 |
| 87275 |
|
12 |
12 |
$109.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
23 |
22 |
$85.47 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
27 |
26 |
$52.98 |
| 82962 |
|
384 |
376 |
$10.49 |
| D0603 |
|
57 |
29 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,562 |
1,528 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
90 |
90 |
$0.00 |
| 99406 |
|
13 |
13 |
$0.00 |
| A0394 |
Als specialized service disposable supplies; iv drug therapy |
18 |
15 |
$0.00 |
| 91300 |
|
37 |
35 |
$0.00 |
| D0400 |
|
80 |
41 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
108 |
108 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
12 |
12 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
32 |
29 |
$0.00 |