| D0999 | N/A | 15 | 150 | 2,140 | $260 | $2M |
| 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… | 102 | 2,520 | 330 | $100 | $352K |
| 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… | 517 | 2,630 | 430 | $90 | $268.2K |
| 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… | 114 | 240 | 550 | $110 | $208.5K |
| 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… | 106 | 260 | 380 | $100 | $161.6K |
| D2392 | Post 2 surface resin‑based composite | 434 | 690 | 290 | $130 | $148K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 97 | 690 | 140 | $90 | $118.4K |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 123 | 290 | 160 | $110 | $111.1K |
| 90460 | In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age. | 57 | 330 | 530 | $30 | $100.6K |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | 153 | 230 | 170 | $70 | $92K |