| 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 |
62,157 |
52,711 |
$4.46M |
| 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 |
14,566 |
9,945 |
$965K |
| D7140 |
Extraction, erupted tooth or exposed root |
6,086 |
2,763 |
$519K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,510 |
4,464 |
$425K |
| D0140 |
Limited oral evaluation - problem focused |
4,143 |
4,008 |
$407K |
| D1110 |
Prophylaxis - adult |
4,268 |
4,237 |
$385K |
| 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 |
4,692 |
4,604 |
$373K |
| D0120 |
Periodic oral evaluation - established patient |
5,032 |
5,000 |
$259K |
| 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 |
2,895 |
2,793 |
$201K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
845 |
632 |
$105K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,022 |
712 |
$105K |
| D0210 |
Intraoral - complete series of radiographic images |
3,877 |
3,835 |
$103K |
| D1120 |
Prophylaxis - child |
2,470 |
2,462 |
$100K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35,250 |
31,041 |
$75K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
630 |
404 |
$72K |
| D1206 |
Topical application of fluoride varnish |
2,561 |
2,553 |
$64K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
386 |
288 |
$38K |
| D0274 |
Bitewings - four radiographic images |
2,306 |
2,285 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,186 |
9,461 |
$28K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
439 |
430 |
$25K |
| D4355 |
|
186 |
185 |
$23K |
| D0220 |
Intraoral - periapical first radiographic image |
3,666 |
3,574 |
$22K |
| D2140 |
|
278 |
202 |
$22K |
| 0012A |
|
710 |
686 |
$20K |
| 90834 |
Psychotherapy, 45 minutes with patient |
6,490 |
4,991 |
$20K |
| 0011A |
|
773 |
746 |
$16K |
| 99000 |
|
1,456 |
1,344 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,484 |
2,445 |
$13K |
| D2160 |
|
106 |
97 |
$12K |
| D0272 |
Bitewings - two radiographic images |
523 |
522 |
$11K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,356 |
2,291 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,056 |
2,036 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,701 |
1,666 |
$8K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,526 |
4,431 |
$8K |
| 0001A |
|
234 |
233 |
$8K |
| H0031 |
Mental health assessment, by non-physician |
368 |
345 |
$8K |
| 0002A |
|
210 |
208 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,298 |
8,112 |
$7K |
| 90837 |
Psychotherapy, 53 minutes with patient |
2,182 |
1,568 |
$6K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,203 |
2,877 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,007 |
1,970 |
$6K |
| D2331 |
|
58 |
40 |
$5K |
| 0064A |
|
144 |
143 |
$5K |
| D0191 |
|
375 |
375 |
$5K |
| Q3014 |
Telehealth originating site facility fee |
597 |
546 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,293 |
1,253 |
$4K |
| 80305 |
|
5,263 |
4,262 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,789 |
4,612 |
$3K |
| 0071A |
|
79 |
79 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,211 |
1,199 |
$3K |
| 0072A |
|
76 |
76 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,649 |
2,630 |
$2K |
| 81025 |
|
3,597 |
3,425 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
17 |
13 |
$2K |
| 99385 |
|
301 |
297 |
$2K |
| 96127 |
|
7,992 |
7,350 |
$2K |
| D2330 |
|
17 |
13 |
$1K |
| 90686 |
|
1,081 |
1,049 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,162 |
2,122 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,268 |
1,216 |
$1K |
| 90480 |
|
42 |
42 |
$1K |
| 0004A |
|
31 |
31 |
$942.41 |
| 99383 |
|
244 |
236 |
$659.30 |
| D0270 |
|
113 |
111 |
$597.93 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
233 |
232 |
$585.93 |
| 90791 |
Psychiatric diagnostic evaluation |
451 |
446 |
$566.57 |
| 82962 |
|
3,026 |
2,895 |
$528.14 |
| 92558 |
|
409 |
408 |
$495.69 |
| 98960 |
|
61 |
59 |
$492.48 |
| D0330 |
Panoramic radiographic image |
54 |
53 |
$489.88 |
| 99382 |
|
80 |
73 |
$466.80 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
107 |
107 |
$466.15 |
| 86328 |
|
31 |
29 |
$411.95 |
| 92551 |
|
881 |
877 |
$348.16 |
| 0031A |
|
13 |
13 |
$340.65 |
| D0190 |
|
25 |
25 |
$336.00 |
| 99406 |
|
836 |
808 |
$315.73 |
| 99384 |
|
93 |
92 |
$198.74 |
| 90715 |
|
208 |
198 |
$98.02 |
| 99381 |
|
68 |
68 |
$86.72 |
| 94010 |
|
14 |
13 |
$80.84 |
| 81002 |
|
563 |
500 |
$69.60 |
| 90473 |
|
91 |
91 |
$24.00 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
13 |
$18.90 |
| 99188 |
|
27 |
26 |
$16.93 |
| D0230 |
Intraoral - periapical each additional radiographic image |
14 |
13 |
$15.30 |
| 81005 |
|
14 |
13 |
$1.79 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,680 |
2,660 |
$0.00 |
| 3008F |
|
618 |
594 |
$0.00 |
| D1330 |
|
528 |
524 |
$0.00 |
| 3080F |
|
223 |
209 |
$0.00 |
| 90698 |
|
84 |
84 |
$0.00 |
| 3079F |
|
132 |
131 |
$0.00 |
| 91301 |
|
61 |
60 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
145 |
145 |
$0.00 |
| 3074F |
|
107 |
104 |
$0.00 |
| 3075F |
|
78 |
78 |
$0.00 |
| 4000F |
|
40 |
39 |
$0.00 |
| 3044F |
|
136 |
136 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
71 |
66 |
$0.00 |
| 99386 |
|
37 |
37 |
$0.00 |
| 93000 |
|
25 |
25 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$0.00 |
| 90651 |
|
30 |
29 |
$0.00 |
| 90744 |
|
47 |
47 |
$0.00 |
| 4004F |
|
61 |
60 |
$0.00 |
| 3725F |
|
1,152 |
1,079 |
$0.00 |
| 90670 |
|
111 |
111 |
$0.00 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
629 |
610 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
182 |
182 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
89 |
87 |
$0.00 |
| 99173 |
|
428 |
427 |
$0.00 |
| 90785 |
|
88 |
68 |
$0.00 |
| 3078F |
|
118 |
112 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
620 |
616 |
$0.00 |
| 90707 |
|
24 |
24 |
$0.00 |
| 90633 |
|
77 |
77 |
$0.00 |
| 3077F |
|
288 |
266 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
22 |
13 |
$0.00 |
| 90734 |
|
16 |
13 |
$0.00 |
| 1160F |
|
230 |
196 |
$0.00 |
| 96158 |
|
21 |
19 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
48 |
42 |
$0.00 |
| 90461 |
|
17 |
17 |
$0.00 |
| 90685 |
|
35 |
35 |
$0.00 |
| 90672 |
|
46 |
45 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27 |
27 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
17 |
17 |
$0.00 |