| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99441 |
|
3,352 |
2,709 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,318 |
4,190 |
$13K |
| 99442 |
|
934 |
660 |
$11K |
| D1208 |
Topical application of fluoride, excluding varnish |
159 |
152 |
$3K |
| D1110 |
Prophylaxis - adult |
65 |
58 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
96 |
87 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
323 |
292 |
$2K |
| D0272 |
Bitewings - two radiographic images |
62 |
62 |
$1K |
| D1120 |
Prophylaxis - child |
57 |
57 |
$1K |
| 99050 |
|
12 |
12 |
$420.00 |
| D0120 |
Periodic oral evaluation - established patient |
28 |
28 |
$327.00 |
| 96160 |
|
53 |
53 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
12 |
12 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
14 |
$0.00 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
23 |
14 |
$0.00 |