| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
5,428 |
4,649 |
$1.12M |
| 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 |
548 |
433 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
125 |
118 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
93 |
70 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
26 |
26 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
171 |
171 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
57 |
57 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
28 |
28 |
$0.00 |
| D1110 |
Prophylaxis - adult |
136 |
135 |
$0.00 |