| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,316 |
3,656 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
434 |
378 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
13 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
77 |
74 |
$0.00 |
| 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 |
122 |
98 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
100 |
98 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
13 |
$0.00 |
| D1351 |
Sealant - per tooth |
33 |
13 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
30 |
$0.00 |
| 99442 |
|
19 |
16 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
43 |
41 |
$0.00 |