| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99252 |
|
1,027 |
990 |
$79K |
| 99253 |
|
571 |
554 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
642 |
638 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
592 |
578 |
$54K |
| 99221 |
|
594 |
575 |
$42K |
| 99222 |
Initial hospital care, per day, moderate complexity |
343 |
334 |
$38K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
405 |
385 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,336 |
3,794 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,083 |
1,346 |
$33K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
415 |
389 |
$32K |
| 99429 |
|
471 |
469 |
$17K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
253 |
209 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
619 |
442 |
$5K |
| 90461 |
|
939 |
786 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
178 |
175 |
$4K |
| 96160 |
|
479 |
454 |
$924.27 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
64 |
$737.32 |
| 97802 |
|
255 |
250 |
$288.34 |
| 96161 |
|
528 |
497 |
$132.66 |
| 90686 |
|
331 |
327 |
$81.33 |
| 90697 |
|
45 |
43 |
$0.01 |
| 90680 |
|
40 |
39 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90723 |
|
26 |
25 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$0.00 |
| 92567 |
|
15 |
14 |
$0.00 |
| 90670 |
|
211 |
206 |
$0.00 |
| 90648 |
|
85 |
83 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |