| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,508 |
3,179 |
$283K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,932 |
2,182 |
$270K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,326 |
1,144 |
$97K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
747 |
672 |
$65K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
712 |
503 |
$41K |
| 92557 |
|
1,325 |
1,156 |
$36K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,025 |
2,607 |
$23K |
| 90686 |
|
787 |
670 |
$11K |
| 99050 |
|
456 |
335 |
$8K |
| D1206 |
Topical application of fluoride varnish |
651 |
374 |
$4K |
| 90698 |
|
324 |
255 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
28 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
316 |
226 |
$3K |
| 90633 |
|
130 |
125 |
$3K |
| 90670 |
|
204 |
140 |
$2K |
| 90656 |
|
92 |
90 |
$2K |
| 99173 |
|
1,006 |
912 |
$2K |
| 90716 |
|
52 |
51 |
$1K |
| 90707 |
|
49 |
48 |
$861.36 |
| 90680 |
|
15 |
12 |
$256.08 |
| 96161 |
|
75 |
75 |
$207.75 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$158.88 |