| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,177 |
10,661 |
$1.73M |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,286 |
2,075 |
$686K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,239 |
2,718 |
$421K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,956 |
1,235 |
$362K |
| D1110 |
Prophylaxis - adult |
5,581 |
1,586 |
$350K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,428 |
1,113 |
$210K |
| 97542 |
|
1,452 |
1,035 |
$132K |
| 92579 |
|
654 |
328 |
$52K |
| D0120 |
Periodic oral evaluation - established patient |
821 |
203 |
$45K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
265 |
264 |
$38K |
| 99215 |
Prolong outpt/office vis |
107 |
106 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
138 |
33 |
$8K |
| 90785 |
|
230 |
109 |
$5K |
| 92567 |
|
104 |
53 |
$5K |
| 99348 |
|
23 |
13 |
$4K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
42 |
12 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
57 |
12 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
16 |
16 |
$3K |
| 99347 |
|
17 |
12 |
$2K |
| 11719 |
|
16 |
13 |
$2K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
13 |
$1K |
| 90836 |
|
15 |
12 |
$804.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
32 |
15 |
$272.94 |