| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
80 |
80 |
$719.10 |
| D1206 |
Topical application of fluoride varnish |
92 |
92 |
$297.50 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,128 |
1,888 |
$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 |
591 |
494 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,085 |
1,811 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
75 |
74 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
63 |
63 |
$0.00 |
| 90688 |
|
15 |
15 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
62 |
49 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
76 |
54 |
$0.00 |
| 98927 |
|
26 |
25 |
$0.00 |