| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1999 |
|
1,256 |
1,062 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,369 |
2,809 |
$15K |
| D1110 |
Prophylaxis - adult |
141 |
141 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
152 |
152 |
$3K |
| 99441 |
|
664 |
538 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
208 |
198 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
114 |
111 |
$2K |
| D0272 |
Bitewings - two radiographic images |
83 |
83 |
$1K |
| D0330 |
Panoramic radiographic image |
47 |
47 |
$921.80 |
| D0120 |
Periodic oral evaluation - established patient |
47 |
46 |
$709.32 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
27 |
$667.56 |
| 90832 |
Psychotherapy, 30 minutes with patient |
116 |
106 |
$623.70 |
| 99401 |
|
244 |
230 |
$608.78 |
| 99442 |
|
77 |
68 |
$594.43 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
346 |
300 |
$413.11 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$300.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$222.45 |
| D1330 |
|
72 |
65 |
$120.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$94.20 |
| 94760 |
|
12 |
12 |
$70.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
89 |
81 |
$58.85 |
| 94664 |
|
12 |
12 |
$58.56 |
| 90658 |
|
50 |
49 |
$40.00 |
| 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 |
14 |
13 |
$40.00 |
| 1160F |
|
459 |
417 |
$0.00 |
| 3078F |
|
1,046 |
926 |
$0.00 |
| 1159F |
|
480 |
434 |
$0.00 |
| 1158F |
|
445 |
401 |
$0.00 |
| 4120F |
|
12 |
12 |
$0.00 |
| 1170F |
|
581 |
509 |
$0.00 |
| 1000F |
|
435 |
396 |
$0.00 |
| 3074F |
|
974 |
859 |
$0.00 |
| 3008F |
|
541 |
473 |
$0.00 |
| 1157F |
|
72 |
62 |
$0.00 |
| 1126F |
|
622 |
566 |
$0.00 |
| 1036F |
|
414 |
378 |
$0.00 |
| 3079F |
|
26 |
24 |
$0.00 |
| 96127 |
|
134 |
90 |
$0.00 |
| 1125F |
|
323 |
284 |
$0.00 |
| 99443 |
|
19 |
15 |
$0.00 |