| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
11,801 |
10,414 |
$2.47M |
| 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 |
3,283 |
2,796 |
$58K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,990 |
1,858 |
$40K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
620 |
609 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
988 |
936 |
$19K |
| D1110 |
Prophylaxis - adult |
444 |
434 |
$17K |
| D1206 |
Topical application of fluoride varnish |
527 |
521 |
$12K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
396 |
319 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
371 |
365 |
$5K |
| D9995 |
|
19 |
19 |
$4K |
| D1120 |
Prophylaxis - child |
193 |
193 |
$3K |
| D0210 |
Intraoral - complete series of radiographic images |
58 |
54 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
69 |
69 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
67 |
67 |
$1K |
| D4341 |
|
22 |
12 |
$815.20 |
| D0274 |
Bitewings - four radiographic images |
41 |
41 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$0.00 |