| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,839 |
9,666 |
$1.99M |
| 99499 |
|
395 |
343 |
$5K |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
362 |
301 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
14 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
654 |
642 |
$247.03 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,608 |
2,429 |
$227.12 |
| D1110 |
Prophylaxis - adult |
301 |
300 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
79 |
76 |
$0.00 |
| D1120 |
Prophylaxis - child |
94 |
93 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
98 |
98 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
37 |
37 |
$0.00 |
| 99173 |
|
48 |
42 |
$0.00 |
| D0190 |
|
124 |
123 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
319 |
316 |
$0.00 |
| D1330 |
|
498 |
493 |
$0.00 |
| D0603 |
|
85 |
85 |
$0.00 |
| D1310 |
|
81 |
79 |
$0.00 |
| 92551 |
|
31 |
31 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
88 |
82 |
$0.00 |
| 90686 |
|
30 |
30 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
15 |
$0.00 |