| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
8,988 |
7,979 |
$1.85M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,612 |
2,340 |
$51K |
| 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 |
3,243 |
2,671 |
$49K |
| H0031 |
Mental health assessment, by non-physician |
282 |
181 |
$48K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
516 |
398 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
497 |
487 |
$5K |
| 90837 |
Psychotherapy, 53 minutes with patient |
16 |
12 |
$373.60 |
| G0470 |
Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit |
21 |
14 |
$63.50 |
| D1206 |
Topical application of fluoride varnish |
517 |
517 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
386 |
386 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
19 |
13 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
12 |
12 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
33 |
32 |
$0.00 |
| D9995 |
|
42 |
41 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
25 |
25 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
53 |
53 |
$0.00 |
| D1120 |
Prophylaxis - child |
485 |
485 |
$0.00 |
| D1110 |
Prophylaxis - adult |
197 |
197 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
232 |
232 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
337 |
334 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
19 |
13 |
$0.00 |