| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,949 |
1,505 |
$90K |
| 92586 |
|
1,072 |
868 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
448 |
332 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
483 |
373 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
256 |
168 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,127 |
964 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
225 |
196 |
$16K |
| 90686 |
|
805 |
696 |
$7K |
| 99173 |
|
987 |
856 |
$7K |
| 90649 |
|
220 |
187 |
$5K |
| 96111 |
|
230 |
150 |
$2K |
| 90620 |
|
48 |
44 |
$2K |
| D1206 |
Topical application of fluoride varnish |
53 |
53 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
328 |
218 |
$1K |
| 90734 |
|
50 |
43 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
37 |
37 |
$949.05 |
| 90715 |
|
70 |
59 |
$922.46 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$903.76 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
59 |
58 |
$716.71 |
| 90700 |
|
54 |
40 |
$362.00 |
| 90685 |
|
42 |
32 |
$347.20 |