| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,764 |
3,100 |
$1.06M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,245 |
1,727 |
$534K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
363 |
296 |
$101K |
| 90837 |
Psychotherapy, 53 minutes with patient |
453 |
177 |
$96K |
| 0011A |
|
503 |
425 |
$81K |
| 0012A |
|
453 |
402 |
$80K |
| D1110 |
Prophylaxis - adult |
85 |
82 |
$27K |
| D0140 |
Limited oral evaluation - problem focused |
110 |
99 |
$25K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
353 |
287 |
$22K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
33 |
$16K |
| 0001A |
|
125 |
114 |
$14K |
| 0002A |
|
131 |
117 |
$12K |
| 90834 |
Psychotherapy, 45 minutes with patient |
62 |
42 |
$11K |
| 0013A |
|
72 |
66 |
$10K |
| D1120 |
Prophylaxis - child |
22 |
17 |
$9K |
| 99215 |
Prolong outpt/office vis |
56 |
39 |
$9K |
| D0120 |
Periodic oral evaluation - established patient |
19 |
18 |
$9K |
| 90832 |
Psychotherapy, 30 minutes with patient |
54 |
43 |
$7K |
| 99442 |
|
14 |
13 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
19 |
14 |
$3K |
| D1354 |
|
176 |
35 |
$2K |
| D0191 |
|
17 |
13 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
300 |
259 |
$365.70 |
| D1206 |
Topical application of fluoride varnish |
411 |
345 |
$160.74 |
| D0274 |
Bitewings - four radiographic images |
58 |
25 |
$84.44 |
| 96160 |
|
13 |
12 |
$21.76 |
| D0220 |
Intraoral - periapical first radiographic image |
175 |
134 |
$12.87 |
| 91301 |
|
439 |
357 |
$0.02 |
| D0330 |
Panoramic radiographic image |
49 |
40 |
$0.00 |
| 91300 |
|
175 |
164 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
149 |
42 |
$0.00 |