| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
192 |
170 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
102 |
91 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
310 |
87 |
$8K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
75 |
72 |
$6K |
| D7140 |
Extraction, erupted tooth or exposed root |
32 |
14 |
$6K |
| D0274 |
Bitewings - four radiographic images |
80 |
79 |
$5K |
| D1110 |
Prophylaxis - adult |
52 |
49 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
106 |
104 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
54 |
40 |
$3K |
| 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 |
64 |
60 |
$2K |