| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,018 |
1,618 |
$223K |
| D0999 |
Unspecified diagnostic procedure, by report |
3,344 |
1,919 |
$184K |
| D0210 |
Intraoral - complete series of radiographic images |
1,297 |
799 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,314 |
807 |
$4K |
| D1110 |
Prophylaxis - adult |
425 |
263 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
55 |
30 |
$54.48 |
| D0274 |
Bitewings - four radiographic images |
34 |
17 |
$34.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
291 |
220 |
$0.00 |
| 11721 |
|
12 |
12 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
692 |
523 |
$0.00 |
| 36416 |
|
279 |
238 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
118 |
79 |
$0.00 |
| 82962 |
|
246 |
207 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
39 |
16 |
$0.00 |