| Code | Description | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
$4.07M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
$1.86M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
$1.55M |
| D0120 |
Periodic oral evaluation - established patient |
$771K |
| D0140 |
Limited oral evaluation - problem focused |
$182K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
$158K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
$94K |
| D0220 |
Intraoral - periapical first radiographic image |
$89K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
$73K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
$60K |