| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
5,372 |
4,363 |
$1.08M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
988 |
940 |
$21K |
| D7140 |
Extraction, erupted tooth or exposed root |
120 |
48 |
$9K |
| 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 |
96 |
25 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
79 |
75 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,388 |
1,218 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
92 |
87 |
$1K |
| 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 |
32 |
30 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$0.00 |
| 91301 |
|
41 |
41 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
13 |
13 |
$0.00 |