| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
14,072 |
12,431 |
$2.57M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,979 |
3,736 |
$13K |
| 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 |
295 |
250 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,575 |
4,287 |
$2K |
| 99215 |
Prolong outpt/office vis |
106 |
93 |
$478.81 |
| D0140 |
Limited oral evaluation - problem focused |
15 |
15 |
$445.50 |
| D0220 |
Intraoral - periapical first radiographic image |
14 |
14 |
$213.36 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
860 |
780 |
$42.76 |
| 36415 |
Collection of venous blood by venipuncture |
1,784 |
1,755 |
$3.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$0.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |