| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,948 |
1,795 |
$143K |
| D1110 |
Prophylaxis - adult |
889 |
888 |
$39K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,052 |
1,039 |
$30K |
| 90832 |
Psychotherapy, 30 minutes with patient |
325 |
177 |
$20K |
| 99406 |
|
1,615 |
1,489 |
$15K |
| D0120 |
Periodic oral evaluation - established patient |
593 |
593 |
$15K |
| 99442 |
|
116 |
115 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
50 |
38 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
86 |
77 |
$924.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
80 |
73 |
$793.32 |
| D0220 |
Intraoral - periapical first radiographic image |
39 |
38 |
$312.00 |
| D0274 |
Bitewings - four radiographic images |
12 |
12 |
$288.00 |
| 80305 |
|
159 |
151 |
$35.00 |
| 3085F |
|
682 |
623 |
$0.00 |
| 1159F |
|
130 |
124 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
26 |
25 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
636 |
595 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
103 |
100 |
$0.00 |
| D9995 |
|
61 |
60 |
$0.00 |