| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
26,214 |
23,700 |
$4.76M |
| 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 |
1,787 |
1,652 |
$56K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,505 |
6,249 |
$31K |
| D7140 |
Extraction, erupted tooth or exposed root |
303 |
124 |
$20K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
1,330 |
1,329 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,223 |
1,922 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
425 |
405 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
14 |
$203.06 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$103.68 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
229 |
229 |
$8.61 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
60 |
60 |
$6.74 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
163 |
163 |
$0.00 |
| 96160 |
|
376 |
376 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$0.00 |
| D0330 |
Panoramic radiographic image |
209 |
209 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
105 |
105 |
$0.00 |
| D1110 |
Prophylaxis - adult |
12 |
12 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
217 |
217 |
$0.00 |
| 36416 |
|
95 |
95 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
43 |
43 |
$0.00 |