| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
10,958 |
8,877 |
$2.23M |
| 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 |
1,194 |
975 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
796 |
680 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
52 |
45 |
$309.73 |
| 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 |
13 |
12 |
$237.42 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
528 |
523 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
172 |
172 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
648 |
606 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
28 |
28 |
$0.00 |
| D1330 |
|
262 |
258 |
$0.00 |
| D0330 |
Panoramic radiographic image |
184 |
184 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
373 |
362 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
297 |
282 |
$0.00 |
| D1110 |
Prophylaxis - adult |
96 |
96 |
$0.00 |