| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,813 |
5,987 |
$515K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,696 |
1,377 |
$295K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
278 |
276 |
$54K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
348 |
305 |
$23K |
| D1110 |
Prophylaxis - adult |
108 |
108 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
129 |
93 |
$17K |
| 99443 |
|
139 |
84 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
84 |
57 |
$9K |
| 99406 |
|
1,819 |
1,057 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
18 |
17 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
18 |
17 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
285 |
275 |
$3K |
| 99442 |
|
99 |
95 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
66 |
55 |
$1K |
| 0001A |
|
36 |
36 |
$1K |
| 0002A |
|
21 |
21 |
$572.30 |
| 99441 |
|
63 |
61 |
$530.08 |
| 90863 |
|
2,753 |
2,585 |
$308.13 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
25 |
$287.76 |
| 82274 |
|
14 |
14 |
$222.88 |
| 92551 |
|
14 |
14 |
$82.04 |
| 82962 |
|
84 |
54 |
$68.56 |
| 94150 |
|
66 |
40 |
$0.00 |
| 91300 |
|
12 |
12 |
$0.00 |