| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
19,647 |
14,806 |
$1.22M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,231 |
6,730 |
$153K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,452 |
3,026 |
$114K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,551 |
975 |
$18K |
| 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 |
2,065 |
1,703 |
$16K |
| 90832 |
Psychotherapy, 30 minutes with patient |
504 |
362 |
$3K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
100 |
98 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
60 |
45 |
$563.62 |
| 80305 |
|
51 |
40 |
$244.03 |
| 90674 |
|
74 |
53 |
$170.00 |
| 81025 |
|
125 |
91 |
$108.75 |
| 87430 |
|
119 |
88 |
$63.00 |
| 81002 |
|
153 |
136 |
$16.94 |
| 3078F |
|
867 |
587 |
$0.02 |
| 3008F |
|
2,961 |
1,815 |
$0.02 |
| 3079F |
|
268 |
173 |
$0.01 |
| 3074F |
|
1,355 |
875 |
$0.01 |
| D0330 |
Panoramic radiographic image |
2,224 |
1,574 |
$0.00 |
| 3077F |
|
43 |
28 |
$0.00 |
| D1110 |
Prophylaxis - adult |
698 |
547 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
306 |
277 |
$0.00 |
| 99408 |
|
131 |
107 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
260 |
213 |
$0.00 |
| 4004F |
|
337 |
236 |
$0.00 |
| D1120 |
Prophylaxis - child |
105 |
58 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
86 |
59 |
$0.00 |
| 3725F |
|
139 |
102 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,306 |
1,655 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
563 |
469 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
16 |
14 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
575 |
305 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
29 |
24 |
$0.00 |
| 99406 |
|
40 |
34 |
$0.00 |
| 1036F |
|
184 |
115 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
108 |
61 |
$0.00 |
| 92551 |
|
28 |
25 |
$0.00 |
| 3075F |
|
33 |
25 |
$0.00 |
| 3044F |
|
25 |
14 |
$0.00 |
| 3080F |
|
20 |
13 |
$0.00 |