| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,914 |
9,205 |
$5.33M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,323 |
3,673 |
$1.51M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,243 |
2,039 |
$943K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,192 |
1,068 |
$603K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
906 |
841 |
$376K |
| W0037 |
|
6,992 |
6,992 |
$223K |
| 90834 |
Psychotherapy, 45 minutes with patient |
385 |
311 |
$220K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
326 |
320 |
$211K |
| 90837 |
Psychotherapy, 53 minutes with patient |
431 |
333 |
$201K |
| 0002A |
|
386 |
372 |
$188K |
| 0001A |
|
393 |
372 |
$187K |
| 0072A |
|
269 |
262 |
$154K |
| 0071A |
|
202 |
197 |
$111K |
| 90832 |
Psychotherapy, 30 minutes with patient |
181 |
142 |
$107K |
| 90791 |
Psychiatric diagnostic evaluation |
153 |
149 |
$95K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
162 |
162 |
$87K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
88 |
$53K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
56 |
52 |
$39K |
| D0220 |
Intraoral - periapical first radiographic image |
192 |
178 |
$35K |
| 0011A |
|
36 |
36 |
$18K |
| 0012A |
|
37 |
36 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
25 |
$16K |
| 0052A |
|
24 |
24 |
$15K |
| 99215 |
Prolong outpt/office vis |
27 |
25 |
$13K |
| 0004A |
|
32 |
32 |
$10K |
| 0051A |
|
16 |
16 |
$10K |
| 0081A |
|
14 |
14 |
$9K |
| 0054A |
|
14 |
14 |
$8K |
| 0082A |
|
13 |
12 |
$7K |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$4K |
| 0124A |
|
16 |
16 |
$3K |
| 98968 |
|
20 |
15 |
$2K |
| 98966 |
|
57 |
46 |
$615.72 |
| D0330 |
Panoramic radiographic image |
38 |
38 |
$427.00 |
| 99441 |
|
16 |
12 |
$158.83 |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
28 |
27 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
14 |
12 |
$0.00 |