| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,148 |
5,820 |
$1.37M |
| D0120 |
Periodic oral evaluation - established patient |
161 |
89 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,277 |
2,915 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,037 |
879 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
62 |
62 |
$435.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
127 |
119 |
$170.18 |
| 99215 |
Prolong outpt/office vis |
184 |
134 |
$77.76 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
121 |
121 |
$61.05 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$48.00 |
| 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 |
165 |
143 |
$0.00 |
| 82962 |
|
538 |
474 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
927 |
844 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
167 |
160 |
$0.00 |
| 99386 |
|
59 |
59 |
$0.00 |
| 99385 |
|
185 |
185 |
$0.00 |
| 97802 |
|
101 |
98 |
$0.00 |
| 99383 |
|
54 |
53 |
$0.00 |
| 90686 |
|
37 |
37 |
$0.00 |
| 90744 |
|
58 |
58 |
$0.00 |
| 92551 |
|
41 |
41 |
$0.00 |
| 90656 |
|
40 |
40 |
$0.00 |
| 99384 |
|
25 |
25 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
17 |
17 |
$0.00 |
| 90710 |
|
37 |
37 |
$0.00 |
| 99173 |
|
301 |
301 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
92 |
87 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
317 |
308 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
95 |
92 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
25 |
$0.00 |
| 90633 |
|
104 |
104 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
86 |
84 |
$0.00 |
| 90713 |
|
15 |
15 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$0.00 |
| 90715 |
|
31 |
31 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |