| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
85,377 |
55,825 |
$11.90M |
| D0999 |
Unspecified diagnostic procedure, by report |
3,624 |
2,333 |
$298K |
| 0011A |
|
260 |
243 |
$9K |
| 0012A |
|
208 |
200 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,892 |
12,058 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,864 |
16,723 |
$5K |
| 0502F |
|
1,394 |
791 |
$3K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,663 |
1,646 |
$3K |
| 0013A |
|
45 |
41 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
764 |
615 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19,681 |
15,742 |
$1K |
| 90791 |
Psychiatric diagnostic evaluation |
1,030 |
713 |
$846.22 |
| 99441 |
|
979 |
755 |
$840.51 |
| D0140 |
Limited oral evaluation - problem focused |
422 |
370 |
$753.48 |
| 99442 |
|
594 |
433 |
$647.40 |
| 0001A |
|
16 |
15 |
$632.10 |
| 0002A |
|
13 |
12 |
$547.82 |
| 90670 |
|
361 |
294 |
$418.66 |
| 99215 |
Prolong outpt/office vis |
928 |
767 |
$392.17 |
| 90633 |
|
410 |
367 |
$219.72 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
547 |
498 |
$215.80 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
64 |
58 |
$180.00 |
| 90715 |
|
259 |
249 |
$134.42 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,643 |
1,358 |
$110.02 |
| 90834 |
Psychotherapy, 45 minutes with patient |
375 |
247 |
$97.40 |
| 81025 |
|
1,665 |
1,445 |
$77.03 |
| 99385 |
|
862 |
778 |
$66.40 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,446 |
1,279 |
$64.30 |
| 90734 |
|
250 |
243 |
$54.40 |
| 81000 |
|
321 |
239 |
$50.82 |
| 90620 |
|
52 |
48 |
$50.13 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
220 |
192 |
$25.61 |
| 82948 |
|
593 |
499 |
$17.20 |
| 90707 |
|
12 |
12 |
$16.71 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
82 |
58 |
$12.88 |
| 99386 |
|
585 |
534 |
$0.00 |
| 99383 |
|
119 |
117 |
$0.00 |
| 99384 |
|
34 |
25 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
328 |
281 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,299 |
607 |
$0.00 |
| D0603 |
|
518 |
399 |
$0.00 |
| 88142 |
|
33 |
31 |
$0.00 |
| D1351 |
Sealant - per tooth |
113 |
48 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
117 |
83 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
34 |
31 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
58 |
58 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
95 |
82 |
$0.00 |
| D4355 |
|
30 |
24 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
48 |
45 |
$0.00 |
| D0601 |
|
33 |
22 |
$0.00 |
| D0602 |
|
40 |
30 |
$0.00 |
| 90723 |
|
19 |
12 |
$0.00 |
| D1120 |
Prophylaxis - child |
441 |
341 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,635 |
1,461 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,216 |
989 |
$0.00 |
| D0330 |
Panoramic radiographic image |
102 |
85 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
888 |
824 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,406 |
1,260 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
336 |
267 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
558 |
441 |
$0.00 |
| 90837 |
Psychotherapy, 53 minutes with patient |
156 |
82 |
$0.00 |
| 99397 |
|
93 |
79 |
$0.00 |
| 81002 |
|
14 |
14 |
$0.00 |
| D1110 |
Prophylaxis - adult |
25 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$0.00 |