| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,690 |
4,778 |
$234K |
| 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 |
4,692 |
3,772 |
$118K |
| D1110 |
Prophylaxis - adult |
976 |
897 |
$82K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,521 |
791 |
$55K |
| D0274 |
Bitewings - four radiographic images |
873 |
794 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
923 |
812 |
$41K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,281 |
1,115 |
$37K |
| D0220 |
Intraoral - periapical first radiographic image |
1,378 |
1,235 |
$36K |
| D7140 |
Extraction, erupted tooth or exposed root |
241 |
60 |
$35K |
| 90834 |
Psychotherapy, 45 minutes with patient |
404 |
226 |
$23K |
| D0330 |
Panoramic radiographic image |
192 |
173 |
$18K |
| D0120 |
Periodic oral evaluation - established patient |
286 |
276 |
$14K |
| D0140 |
Limited oral evaluation - problem focused |
185 |
169 |
$13K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
84 |
72 |
$5K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
20 |
12 |
$5K |
| 99334 |
|
108 |
88 |
$3K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
26 |
23 |
$455.96 |
| 36415 |
Collection of venous blood by venipuncture |
124 |
117 |
$59.40 |