| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,559 |
3,296 |
$380K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
442 |
428 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
163 |
149 |
$23K |
| 82962 |
|
809 |
772 |
$11K |
| D1110 |
Prophylaxis - adult |
147 |
131 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
35 |
25 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
127 |
108 |
$4K |
| D0274 |
Bitewings - four radiographic images |
97 |
79 |
$4K |
| 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 |
69 |
64 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
38 |
31 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
67 |
60 |
$1K |
| 81002 |
|
75 |
62 |
$415.98 |
| G9920 |
Screening performed and negative |
201 |
193 |
$0.00 |