| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,624 |
10,376 |
$3.25M |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,153 |
1,958 |
$419K |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,225 |
1,463 |
$321K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,116 |
999 |
$176K |
| D0140 |
Limited oral evaluation - problem focused |
1,207 |
861 |
$155K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,178 |
667 |
$145K |
| 90834 |
Psychotherapy, 45 minutes with patient |
637 |
413 |
$111K |
| 90791 |
Psychiatric diagnostic evaluation |
568 |
558 |
$97K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
520 |
355 |
$77K |
| D5211 |
|
215 |
189 |
$35K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
183 |
147 |
$34K |
| 99442 |
|
202 |
123 |
$27K |
| D0210 |
Intraoral - complete series of radiographic images |
175 |
162 |
$25K |
| D0274 |
Bitewings - four radiographic images |
232 |
205 |
$22K |
| D7140 |
Extraction, erupted tooth or exposed root |
94 |
80 |
$19K |
| D0470 |
|
77 |
61 |
$13K |
| D9110 |
|
64 |
58 |
$13K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
58 |
50 |
$12K |
| 99402 |
|
61 |
61 |
$10K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
112 |
91 |
$9K |
| D2330 |
|
42 |
38 |
$8K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
53 |
37 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
96 |
71 |
$7K |
| D0270 |
|
44 |
42 |
$6K |
| 99441 |
|
46 |
28 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
57 |
48 |
$2K |
| D5110 |
|
13 |
13 |
$2K |
| 93268 |
|
81 |
81 |
$2K |
| 0012A |
|
48 |
48 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
43 |
43 |
$864.10 |
| 0011A |
|
28 |
28 |
$610.91 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,134 |
689 |
$484.88 |
| 87390 |
|
64 |
64 |
$230.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
31 |
$150.00 |
| 90863 |
|
232 |
165 |
$137.26 |
| 90658 |
|
41 |
41 |
$71.78 |
| 99406 |
|
12 |
12 |
$54.32 |
| 87391 |
|
24 |
24 |
$39.58 |
| 99173 |
|
28 |
28 |
$3.54 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
36 |
29 |
$0.00 |
| 94012 |
|
13 |
13 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |