| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0230 |
Intraoral - periapical each additional radiographic image |
901 |
235 |
$25K |
| D0220 |
Intraoral - periapical first radiographic image |
723 |
638 |
$22K |
| D7140 |
Extraction, erupted tooth or exposed root |
77 |
24 |
$13K |
| D0274 |
Bitewings - four radiographic images |
99 |
89 |
$6K |
| 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 |
185 |
75 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
70 |
58 |
$5K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
143 |
100 |
$4K |
| D0330 |
Panoramic radiographic image |
14 |
12 |
$2K |
| 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 |
38 |
36 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
24 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
88 |
43 |
$0.00 |