| 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 |
71,085 |
62,100 |
$4.89M |
| 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 |
9,502 |
9,329 |
$697K |
| 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 |
8,659 |
8,581 |
$630K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42,830 |
38,905 |
$80K |
| D1110 |
Prophylaxis - adult |
705 |
701 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14,998 |
14,493 |
$37K |
| 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 |
478 |
447 |
$32K |
| 59426 |
|
39 |
38 |
$31K |
| D0140 |
Limited oral evaluation - problem focused |
425 |
413 |
$30K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
426 |
423 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,427 |
4,402 |
$19K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
2,525 |
2,309 |
$19K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
4,412 |
4,264 |
$15K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
4,593 |
4,468 |
$13K |
| D0210 |
Intraoral - complete series of radiographic images |
329 |
326 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,045 |
4,027 |
$13K |
| D4355 |
|
146 |
137 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,987 |
4,666 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,844 |
2,781 |
$9K |
| 99406 |
|
3,622 |
3,524 |
$8K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,754 |
1,680 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,625 |
2,614 |
$8K |
| 99385 |
|
1,521 |
1,504 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,997 |
3,936 |
$6K |
| 81025 |
|
3,085 |
2,863 |
$6K |
| G0469 |
Federally qualified health center (fqhc) visit, mental health, new patient; a medically-necessary, face-to-face mental health 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 mental health visit |
82 |
81 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,779 |
1,674 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,853 |
5,776 |
$5K |
| 99383 |
|
1,108 |
1,103 |
$5K |
| 99382 |
|
720 |
720 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
56 |
28 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,334 |
3,203 |
$4K |
| 92567 |
|
4,501 |
4,478 |
$4K |
| 83655 |
|
684 |
641 |
$4K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
1,130 |
1,113 |
$3K |
| D0120 |
Periodic oral evaluation - established patient |
42 |
41 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,237 |
1,234 |
$3K |
| 99381 |
|
952 |
941 |
$3K |
| D1120 |
Prophylaxis - child |
65 |
65 |
$3K |
| 99401 |
|
600 |
595 |
$3K |
| 81002 |
|
2,850 |
2,615 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
255 |
246 |
$2K |
| D0274 |
Bitewings - four radiographic images |
71 |
68 |
$2K |
| 99384 |
|
762 |
760 |
$2K |
| 99215 |
Prolong outpt/office vis |
944 |
937 |
$2K |
| 96127 |
|
6,220 |
6,155 |
$2K |
| D1206 |
Topical application of fluoride varnish |
92 |
92 |
$2K |
| 99386 |
|
664 |
658 |
$2K |
| 90662 |
|
65 |
65 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
286 |
278 |
$1K |
| 99442 |
|
515 |
506 |
$1K |
| 90677 |
|
277 |
277 |
$1K |
| 83037 |
|
459 |
456 |
$935.70 |
| 76801 |
|
59 |
54 |
$782.06 |
| 81001 |
|
575 |
525 |
$723.95 |
| 36415 |
Collection of venous blood by venipuncture |
1,155 |
1,146 |
$696.90 |
| 92551 |
|
369 |
330 |
$691.43 |
| 99402 |
|
36 |
36 |
$685.40 |
| 90658 |
|
497 |
489 |
$673.41 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
833 |
809 |
$592.26 |
| 59430 |
|
12 |
12 |
$587.88 |
| 90734 |
|
1,385 |
1,366 |
$386.55 |
| 90670 |
|
1,699 |
1,669 |
$376.01 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
179 |
176 |
$354.58 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
142 |
141 |
$340.72 |
| 90716 |
|
280 |
279 |
$339.00 |
| 90649 |
|
1,001 |
991 |
$310.06 |
| 90651 |
|
402 |
399 |
$276.34 |
| 90686 |
|
1,729 |
1,712 |
$271.78 |
| 90837 |
Psychotherapy, 53 minutes with patient |
152 |
143 |
$259.12 |
| 90620 |
|
363 |
361 |
$236.38 |
| 90707 |
|
824 |
820 |
$231.46 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
982 |
977 |
$209.04 |
| 90715 |
|
801 |
795 |
$186.78 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
150 |
148 |
$177.69 |
| 86580 |
|
431 |
422 |
$170.55 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
13 |
13 |
$140.85 |
| 99443 |
|
12 |
12 |
$122.48 |
| 10120 |
|
17 |
17 |
$88.35 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
934 |
931 |
$74.58 |
| Q3014 |
Telehealth originating site facility fee |
49 |
47 |
$73.56 |
| 90710 |
|
617 |
608 |
$63.00 |
| 90396 |
|
95 |
95 |
$56.28 |
| 99441 |
|
84 |
84 |
$55.44 |
| G0008 |
Administration of influenza virus vaccine |
101 |
101 |
$55.39 |
| 90832 |
Psychotherapy, 30 minutes with patient |
12 |
12 |
$44.57 |
| 82948 |
|
383 |
382 |
$41.80 |
| 90680 |
|
879 |
855 |
$37.50 |
| 90647 |
|
1,363 |
1,341 |
$30.70 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
60 |
57 |
$12.88 |
| 96161 |
|
57 |
53 |
$3.55 |
| 90696 |
|
547 |
540 |
$0.01 |
| 90656 |
|
201 |
200 |
$0.01 |
| 94760 |
|
135 |
128 |
$0.00 |
| 90619 |
|
104 |
104 |
$0.00 |
| 90698 |
|
272 |
266 |
$0.00 |
| 90723 |
|
1,370 |
1,349 |
$0.00 |
| 90657 |
|
92 |
92 |
$0.00 |
| 3351F |
|
275 |
271 |
$0.00 |
| 90732 |
|
95 |
94 |
$0.00 |
| 0500F |
|
25 |
24 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
19 |
19 |
$0.00 |
| 84703 |
|
63 |
62 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
14 |
$0.00 |
| 1220F |
|
138 |
137 |
$0.00 |
| 90688 |
|
66 |
64 |
$0.00 |
| 90744 |
|
29 |
29 |
$0.00 |
| 92228 |
|
12 |
12 |
$0.00 |
| 90700 |
|
432 |
424 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
349 |
346 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
385 |
376 |
$0.00 |
| 99173 |
|
2,829 |
2,816 |
$0.00 |
| 90461 |
|
2,694 |
2,658 |
$0.00 |
| 90633 |
|
1,707 |
1,692 |
$0.00 |
| 0502F |
|
971 |
308 |
$0.00 |
| 90681 |
|
40 |
39 |
$0.00 |
| 90713 |
|
24 |
24 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
28 |
28 |
$0.00 |
| 1160F |
|
12 |
12 |
$0.00 |
| 90473 |
|
13 |
13 |
$0.00 |