| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99499 |
|
26,013 |
23,279 |
$3.03M |
| D7999 |
|
36,810 |
8,160 |
$1.02M |
| D1110 |
Prophylaxis - adult |
6,405 |
6,332 |
$214K |
| D0120 |
Periodic oral evaluation - established patient |
4,623 |
4,589 |
$92K |
| D0274 |
Bitewings - four radiographic images |
3,968 |
3,943 |
$71K |
| D0220 |
Intraoral - periapical first radiographic image |
7,181 |
7,130 |
$64K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
1,221 |
1,059 |
$60K |
| D1120 |
Prophylaxis - child |
1,795 |
1,787 |
$60K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,387 |
1,098 |
$45K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,000 |
1,948 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
590 |
570 |
$37K |
| D0230 |
Intraoral - periapical each additional radiographic image |
4,553 |
4,535 |
$25K |
| D0330 |
Panoramic radiographic image |
936 |
935 |
$17K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,268 |
1,268 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
154 |
142 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
1,319 |
1,290 |
$13K |
| D0272 |
Bitewings - two radiographic images |
682 |
682 |
$9K |
| D0210 |
Intraoral - complete series of radiographic images |
1,635 |
1,627 |
$8K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
66 |
66 |
$4K |
| 90832 |
Psychotherapy, 30 minutes with patient |
24 |
21 |
$4K |
| 3074F |
|
327 |
295 |
$3K |
| D1206 |
Topical application of fluoride varnish |
70 |
70 |
$2K |
| D0270 |
|
164 |
163 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
15 |
$1K |
| 0011A |
|
50 |
50 |
$1K |
| 0012A |
|
38 |
38 |
$1K |
| 99441 |
|
14 |
14 |
$621.26 |
| D9110 |
|
24 |
24 |
$342.24 |
| D0160 |
|
15 |
15 |
$259.34 |
| 3078F |
|
142 |
135 |
$223.19 |
| D1330 |
|
2,645 |
2,637 |
$203.58 |
| 1170F |
|
143 |
123 |
$97.98 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
22 |
22 |
$0.00 |