| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,582 |
15,670 |
$1.60M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,610 |
4,184 |
$453K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,516 |
2,272 |
$226K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,066 |
969 |
$138K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
474 |
439 |
$50K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
368 |
325 |
$43K |
| D1120 |
Prophylaxis - child |
138 |
138 |
$12K |
| D1110 |
Prophylaxis - adult |
192 |
190 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
112 |
112 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
147 |
144 |
$4K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
31 |
25 |
$4K |
| D0330 |
Panoramic radiographic image |
61 |
59 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
102 |
101 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$2K |
| D0274 |
Bitewings - four radiographic images |
46 |
45 |
$320.52 |
| D1206 |
Topical application of fluoride varnish |
52 |
52 |
$152.97 |
| D0220 |
Intraoral - periapical first radiographic image |
16 |
16 |
$112.00 |
| 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 |
3,429 |
3,114 |
$0.00 |
| D0601 |
|
13 |
13 |
$0.00 |
| D0603 |
|
67 |
67 |
$0.00 |
| G8732 |
No documentation of pain assessment, reason not given |
14 |
12 |
$0.00 |
| G8432 |
Depression screening not documented, reason not given |
12 |
12 |
$0.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
14 |
12 |
$0.00 |