| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,116 |
10,084 |
$1.51M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,709 |
7,098 |
$1.18M |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,185 |
903 |
$195K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
358 |
304 |
$64K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
220 |
218 |
$43K |
| 90837 |
Psychotherapy, 53 minutes with patient |
291 |
190 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
176 |
175 |
$41K |
| D7140 |
Extraction, erupted tooth or exposed root |
852 |
251 |
$33K |
| T1015 |
Clinic visit/encounter, all-inclusive |
141 |
137 |
$30K |
| D0140 |
Limited oral evaluation - problem focused |
408 |
361 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
51 |
$10K |
| 99215 |
Prolong outpt/office vis |
31 |
31 |
$6K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
47 |
41 |
$726.44 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
15 |
14 |
$505.71 |
| D0220 |
Intraoral - periapical first radiographic image |
72 |
57 |
$421.40 |
| D1110 |
Prophylaxis - adult |
13 |
12 |
$291.40 |
| D0274 |
Bitewings - four radiographic images |
16 |
13 |
$238.04 |