| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,481 |
1,313 |
$97K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,444 |
1,191 |
$61K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
670 |
563 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
236 |
198 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
239 |
208 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
104 |
96 |
$7K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
81 |
77 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
40 |
$3K |
| 90686 |
|
195 |
162 |
$1K |
| D1206 |
Topical application of fluoride varnish |
35 |
30 |
$952.07 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
60 |
57 |
$854.78 |
| 90670 |
|
126 |
105 |
$787.20 |
| 90698 |
|
115 |
85 |
$723.20 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
53 |
50 |
$304.22 |
| 36415 |
Collection of venous blood by venipuncture |
52 |
49 |
$53.30 |
| 99188 |
|
31 |
25 |
$0.00 |