| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
852 |
803 |
$572K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,721 |
1,526 |
$419K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,109 |
880 |
$231K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
256 |
245 |
$24K |
| D0274 |
Bitewings - four radiographic images |
268 |
146 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
174 |
140 |
$8K |
| D0190 |
|
36 |
12 |
$7K |
| D1110 |
Prophylaxis - adult |
165 |
156 |
$6K |
| 90837 |
Psychotherapy, 53 minutes with patient |
17 |
12 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
230 |
217 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
97 |
92 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
18 |
$5K |
| D0330 |
Panoramic radiographic image |
50 |
44 |
$1K |
| 99173 |
|
28 |
24 |
$967.40 |
| 36415 |
Collection of venous blood by venipuncture |
113 |
111 |
$745.04 |
| D1208 |
Topical application of fluoride, excluding varnish |
53 |
52 |
$719.00 |
| 96127 |
|
38 |
24 |
$174.46 |
| 90686 |
|
36 |
36 |
$83.52 |
| D0230 |
Intraoral - periapical each additional radiographic image |
165 |
82 |
$0.00 |
| D9996 |
|
16 |
16 |
$0.00 |