| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,148 |
4,238 |
$414K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,105 |
2,790 |
$184K |
| 90832 |
Psychotherapy, 30 minutes with patient |
405 |
256 |
$18K |
| 99215 |
Prolong outpt/office vis |
102 |
99 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
61 |
53 |
$8K |
| D0330 |
Panoramic radiographic image |
112 |
103 |
$8K |
| D0274 |
Bitewings - four radiographic images |
123 |
118 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
74 |
70 |
$4K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
28 |
27 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$2K |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$868.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$655.90 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
29 |
28 |
$406.28 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$264.84 |