| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99291 |
Critical care, evaluation and management of the critically ill patient, first 30-74 minutes |
1,867 |
901 |
$251K |
| D0140 |
Limited oral evaluation - problem focused |
1,543 |
1,529 |
$86K |
| 95800 |
|
2,594 |
2,534 |
$76K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,156 |
790 |
$75K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,605 |
1,551 |
$73K |
| D1110 |
Prophylaxis - adult |
758 |
757 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
1,115 |
1,114 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
593 |
571 |
$19K |
| 94729 |
|
2,022 |
1,966 |
$15K |
| 94726 |
|
1,486 |
1,449 |
$14K |
| 94060 |
|
1,734 |
1,688 |
$13K |
| D0220 |
Intraoral - periapical first radiographic image |
1,319 |
1,306 |
$11K |
| 94375 |
|
467 |
448 |
$10K |
| 95811 |
|
68 |
68 |
$10K |
| D1206 |
Topical application of fluoride varnish |
544 |
542 |
$10K |
| D0274 |
Bitewings - four radiographic images |
342 |
342 |
$10K |
| 99215 |
Prolong outpt/office vis |
125 |
123 |
$9K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
152 |
128 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
90 |
88 |
$8K |
| D1120 |
Prophylaxis - child |
211 |
210 |
$6K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
97 |
76 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
195 |
195 |
$5K |
| 95810 |
Polysomnography; sleep staging with 4 or more additional parameters |
51 |
51 |
$4K |
| D0330 |
Panoramic radiographic image |
131 |
131 |
$4K |
| 99205 |
Prolong outpt/office vis |
27 |
27 |
$4K |
| D9920 |
|
25 |
25 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
48 |
46 |
$3K |
| 94727 |
|
88 |
87 |
$2K |
| D1330 |
|
202 |
202 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
44 |
44 |
$1K |
| 99233 |
Prolong inpt eval add15 m |
50 |
25 |
$504.22 |
| D0210 |
Intraoral - complete series of radiographic images |
12 |
12 |
$490.09 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
38 |
16 |
$429.76 |
| D0270 |
|
43 |
43 |
$340.80 |
| D0272 |
Bitewings - two radiographic images |
14 |
14 |
$235.92 |
| D1310 |
|
44 |
44 |
$184.35 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
18 |
17 |
$138.38 |
| D0230 |
Intraoral - periapical each additional radiographic image |
14 |
14 |
$120.96 |