| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,425 |
6,492 |
$1.55M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
150 |
140 |
$435.36 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
199 |
190 |
$359.91 |
| D0230 |
Intraoral - periapical each additional radiographic image |
58 |
34 |
$0.00 |
| 1101F |
|
41 |
39 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
39 |
38 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
42 |
41 |
$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 |
13 |
13 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
15 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
99 |
98 |
$0.00 |
| 1160F |
|
128 |
122 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
31 |
31 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
12 |
$0.00 |
| 3288F |
|
14 |
14 |
$0.00 |
| 81003 |
|
16 |
12 |
$0.00 |