| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,705 |
2,108 |
$351K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,783 |
2,986 |
$255K |
| 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 |
1,274 |
1,181 |
$35K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,006 |
288 |
$30K |
| D0220 |
Intraoral - periapical first radiographic image |
867 |
772 |
$26K |
| D0274 |
Bitewings - four radiographic images |
253 |
238 |
$17K |
| D0330 |
Panoramic radiographic image |
124 |
119 |
$14K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
508 |
415 |
$12K |
| D1110 |
Prophylaxis - adult |
55 |
53 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
41 |
38 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
36 |
29 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
26 |
25 |
$2K |