| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,908 |
2,609 |
$135K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,526 |
1,336 |
$104K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,378 |
1,220 |
$96K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,205 |
1,046 |
$93K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
1,257 |
910 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
265 |
249 |
$20K |
| 90677 |
|
360 |
324 |
$12K |
| 90723 |
|
651 |
564 |
$10K |
| 90647 |
|
631 |
512 |
$10K |
| 90686 |
|
946 |
856 |
$9K |
| 90670 |
|
653 |
565 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
60 |
58 |
$5K |
| 90681 |
|
278 |
241 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
151 |
134 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
52 |
46 |
$3K |
| 90633 |
|
184 |
158 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
71 |
68 |
$2K |
| 90656 |
|
88 |
84 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
112 |
105 |
$1K |
| 90698 |
|
172 |
140 |
$1K |
| 90381 |
|
58 |
46 |
$969.18 |
| D1206 |
Topical application of fluoride varnish |
27 |
26 |
$676.00 |
| 90734 |
|
50 |
43 |
$594.31 |
| 90651 |
|
45 |
42 |
$521.41 |
| 90680 |
|
74 |
64 |
$422.40 |
| 90685 |
|
37 |
34 |
$317.27 |
| 90700 |
|
18 |
14 |
$300.78 |
| 90380 |
|
17 |
12 |
$284.07 |
| 99318 |
|
16 |
16 |
$254.10 |
| 90715 |
|
34 |
31 |
$250.81 |
| 90672 |
|
14 |
14 |
$114.18 |
| 90710 |
|
12 |
12 |
$76.80 |
| 90744 |
|
12 |
12 |
$76.80 |