| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,300 |
2,932 |
$256K |
| D7140 |
Extraction, erupted tooth or exposed root |
990 |
557 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
996 |
886 |
$54K |
| 90837 |
Psychotherapy, 53 minutes with patient |
236 |
123 |
$26K |
| D0210 |
Intraoral - complete series of radiographic images |
841 |
805 |
$25K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
998 |
972 |
$23K |
| D0274 |
Bitewings - four radiographic images |
989 |
966 |
$19K |
| D1110 |
Prophylaxis - adult |
438 |
433 |
$13K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
68 |
63 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
100 |
90 |
$5K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
27 |
14 |
$4K |
| D0330 |
Panoramic radiographic image |
59 |
59 |
$3K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17 |
14 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
190 |
183 |
$943.54 |
| D0220 |
Intraoral - periapical first radiographic image |
73 |
66 |
$659.62 |
| 36415 |
Collection of venous blood by venipuncture |
339 |
309 |
$587.72 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
42 |
38 |
$330.14 |
| 96127 |
|
51 |
28 |
$226.54 |
| 99000 |
|
112 |
100 |
$128.80 |
| 36416 |
|
15 |
12 |
$1.01 |
| D0120 |
Periodic oral evaluation - established patient |
182 |
180 |
$0.00 |