| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,616 |
8,503 |
$1.24M |
| T1015 |
Clinic visit/encounter, all-inclusive |
21,080 |
19,515 |
$729K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,511 |
4,176 |
$630K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
1,336 |
834 |
$182K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,240 |
574 |
$102K |
| D1110 |
Prophylaxis - adult |
1,651 |
1,651 |
$80K |
| D0330 |
Panoramic radiographic image |
1,285 |
1,283 |
$67K |
| 80305 |
|
5,312 |
5,094 |
$51K |
| D0274 |
Bitewings - four radiographic images |
1,736 |
1,736 |
$46K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,093 |
1,092 |
$44K |
| D0120 |
Periodic oral evaluation - established patient |
1,623 |
1,623 |
$37K |
| 90832 |
Psychotherapy, 30 minutes with patient |
221 |
205 |
$30K |
| D0140 |
Limited oral evaluation - problem focused |
554 |
552 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
98 |
98 |
$13K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
96 |
76 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
640 |
633 |
$8K |
| 90834 |
Psychotherapy, 45 minutes with patient |
51 |
40 |
$7K |
| 99401 |
|
99 |
99 |
$7K |
| D1120 |
Prophylaxis - child |
147 |
147 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
57 |
40 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
325 |
280 |
$3K |
| D1206 |
Topical application of fluoride varnish |
175 |
175 |
$3K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
14 |
12 |
$2K |
| 72110 |
|
44 |
42 |
$739.84 |
| D0272 |
Bitewings - two radiographic images |
34 |
34 |
$714.00 |
| 98968 |
|
15 |
12 |
$456.15 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
25 |
$158.88 |
| 96127 |
|
444 |
433 |
$0.01 |