| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
995 |
785 |
$126K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,031 |
800 |
$114K |
| H2020 |
Therapeutic behavioral services, per diem |
225 |
96 |
$15K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
19 |
14 |
$47.37 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
378 |
283 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37 |
27 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
51 |
28 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
18 |
15 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
190 |
67 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
31 |
28 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
18 |
15 |
$0.00 |