| G9011 | Coordinated care fee, risk adjusted maintenance, level 5 | 1 | 10 | 8,390 | $80 | $709.6K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 29 | 1,820 | 480 | $60 | $379.6K |
| G9001 | Coordinated care fee, initial rate | 1 | 10 | 2,430 | $120 | $300.8K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 8 | 1,860 | 610 | $40 | $295.5K |
| D2392 | Post 2 surface resin‑based composite | 61 | 540 | 990 | $60 | $188.6K |
| 99391 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 15 | 280 | 540 | $70 | $166.5K |
| 99392 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 22 | 300 | 400 | $80 | $164.4K |
| 90834 | In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere… | 262 | 390 | 420 | $50 | $152.3K |
| D0120 | Periodic oral evaluation - established patient | 56 | 920 | 690 | $20 | $131.3K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 191 | 540 | 130 | $90 | $128.6K |