| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,011 |
1,587 |
$243K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,236 |
1,787 |
$191K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
625 |
581 |
$27K |
| D0230 |
Intraoral - periapical each additional radiographic image |
723 |
243 |
$21K |
| D0220 |
Intraoral - periapical first radiographic image |
650 |
604 |
$20K |
| 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 |
654 |
617 |
$16K |
| D7140 |
Extraction, erupted tooth or exposed root |
46 |
12 |
$9K |
| D0274 |
Bitewings - four radiographic images |
106 |
102 |
$7K |
| D0330 |
Panoramic radiographic image |
41 |
39 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
51 |
48 |
$3K |
| D1110 |
Prophylaxis - adult |
14 |
13 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
18 |
17 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
26 |
26 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
12 |
$901.94 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
29 |
24 |
$753.77 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
20 |
19 |
$629.00 |