| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,482 |
4,913 |
$333K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,499 |
3,117 |
$231K |
| D0230 |
Intraoral - periapical each additional radiographic image |
6,758 |
834 |
$185K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
3,513 |
1,141 |
$144K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,949 |
1,843 |
$122K |
| D1110 |
Prophylaxis - adult |
1,939 |
1,852 |
$97K |
| D9920 |
|
824 |
375 |
$80K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
472 |
431 |
$46K |
| D0220 |
Intraoral - periapical first radiographic image |
1,510 |
1,375 |
$45K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,174 |
469 |
$41K |
| D0210 |
Intraoral - complete series of radiographic images |
291 |
263 |
$36K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
1,552 |
539 |
$35K |
| D1206 |
Topical application of fluoride varnish |
2,770 |
2,598 |
$15K |
| D0330 |
Panoramic radiographic image |
130 |
123 |
$14K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
428 |
173 |
$12K |
| 96156 |
|
463 |
389 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
2,183 |
2,054 |
$12K |
| D0412 |
|
868 |
794 |
$11K |
| D4910 |
|
165 |
142 |
$10K |
| 96151 |
|
282 |
226 |
$8K |
| D4342 |
|
199 |
123 |
$6K |
| 97116 |
|
122 |
52 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
2,165 |
2,042 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
44 |
43 |
$3K |
| 99443 |
|
77 |
60 |
$2K |
| D0274 |
Bitewings - four radiographic images |
43 |
33 |
$1K |
| 90686 |
|
113 |
101 |
$1K |
| 93000 |
|
41 |
41 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
28 |
$973.97 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
26 |
26 |
$942.42 |
| D0140 |
Limited oral evaluation - problem focused |
14 |
13 |
$776.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$678.75 |
| 99442 |
|
34 |
28 |
$398.20 |
| 99441 |
|
30 |
26 |
$343.77 |
| D9215 |
|
441 |
397 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$0.00 |
| D0411 |
|
25 |
24 |
$0.00 |
| D1330 |
|
15 |
12 |
$0.00 |
| D0350 |
|
462 |
425 |
$0.00 |
| D1999 |
|
4,620 |
4,029 |
$0.00 |
| D0180 |
|
174 |
170 |
$0.00 |
| D9910 |
|
15 |
13 |
$0.00 |