| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,430 |
6,446 |
$1.09M |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,283 |
565 |
$193K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
799 |
717 |
$123K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
618 |
551 |
$87K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,322 |
540 |
$70K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
758 |
325 |
$63K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
275 |
239 |
$38K |
| D0431 |
|
890 |
194 |
$35K |
| D1110 |
Prophylaxis - adult |
805 |
202 |
$32K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
191 |
182 |
$27K |
| D0180 |
|
566 |
139 |
$20K |
| D0140 |
Limited oral evaluation - problem focused |
96 |
65 |
$11K |
| 99442 |
|
45 |
43 |
$7K |
| D0210 |
Intraoral - complete series of radiographic images |
126 |
40 |
$6K |
| 97803 |
|
29 |
28 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
25 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
32 |
16 |
$4K |
| 97802 |
|
14 |
14 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$2K |
| D0190 |
|
21 |
16 |
$1K |