| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90834 |
Psychotherapy, 45 minutes with patient |
895 |
441 |
$76K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
517 |
465 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
220 |
208 |
$23K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
117 |
110 |
$14K |
| D1110 |
Prophylaxis - adult |
152 |
142 |
$12K |
| D0274 |
Bitewings - four radiographic images |
191 |
176 |
$11K |
| D0230 |
Intraoral - periapical each additional radiographic image |
451 |
136 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
346 |
308 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
36 |
35 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
60 |
55 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
50 |
49 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
16 |
15 |
$901.44 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
22 |
18 |
$769.68 |
| 86703 |
|
14 |
14 |
$706.00 |