| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,883 |
15,113 |
$2.69M |
| 90832 |
Psychotherapy, 30 minutes with patient |
10,932 |
5,075 |
$1.73M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,808 |
1,485 |
$254K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,261 |
1,113 |
$192K |
| D0180 |
|
2,282 |
526 |
$70K |
| D0120 |
Periodic oral evaluation - established patient |
1,749 |
404 |
$51K |
| D1110 |
Prophylaxis - adult |
853 |
483 |
$34K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
853 |
182 |
$28K |
| 90834 |
Psychotherapy, 45 minutes with patient |
134 |
72 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
160 |
147 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
162 |
137 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
142 |
134 |
$22K |
| 99442 |
|
109 |
99 |
$17K |
| D0140 |
Limited oral evaluation - problem focused |
353 |
212 |
$16K |
| D0220 |
Intraoral - periapical first radiographic image |
745 |
363 |
$15K |
| D9996 |
|
202 |
85 |
$13K |
| 97802 |
|
67 |
67 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
63 |
56 |
$10K |
| 97803 |
|
47 |
41 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
45 |
38 |
$7K |
| D0274 |
Bitewings - four radiographic images |
249 |
175 |
$6K |
| D0210 |
Intraoral - complete series of radiographic images |
116 |
88 |
$4K |
| D0170 |
|
48 |
20 |
$3K |
| D0431 |
|
112 |
56 |
$2K |
| 99443 |
|
12 |
12 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
12 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$2K |
| D9995 |
|
59 |
44 |
$2K |
| D0190 |
|
171 |
154 |
$2K |
| D1206 |
Topical application of fluoride varnish |
34 |
13 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
151 |
147 |
$1K |
| D1310 |
|
54 |
52 |
$264.78 |
| D0601 |
|
12 |
12 |
$0.00 |
| D1330 |
|
50 |
50 |
$0.00 |