| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,917 |
2,473 |
$253K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,657 |
1,489 |
$207K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,169 |
1,100 |
$135K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,174 |
1,124 |
$125K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
449 |
414 |
$46K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,180 |
2,983 |
$27K |
| 92551 |
|
2,794 |
2,641 |
$26K |
| 90686 |
|
1,157 |
1,091 |
$26K |
| D1206 |
Topical application of fluoride varnish |
913 |
913 |
$23K |
| 99070 |
|
3,145 |
2,551 |
$14K |
| 96127 |
|
3,066 |
2,889 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
203 |
180 |
$11K |
| 99173 |
|
3,066 |
2,898 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
538 |
511 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
405 |
382 |
$5K |
| 92552 |
|
173 |
161 |
$4K |
| 90651 |
|
141 |
132 |
$3K |
| 90620 |
|
140 |
124 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$2K |
| 90734 |
|
101 |
96 |
$2K |
| 90461 |
|
130 |
124 |
$2K |
| 90648 |
|
55 |
54 |
$1K |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
118 |
115 |
$1K |
| 90677 |
|
13 |
12 |
$810.12 |
| 90670 |
|
35 |
31 |
$721.68 |
| 99050 |
|
71 |
68 |
$692.44 |
| 90633 |
|
34 |
28 |
$651.84 |
| 90723 |
|
27 |
27 |
$605.28 |
| 90619 |
|
16 |
15 |
$372.48 |
| 90710 |
|
18 |
14 |
$325.92 |
| 99051 |
|
44 |
43 |
$312.60 |
| 90715 |
|
12 |
12 |
$279.36 |
| 99072 |
|
4,136 |
3,437 |
$247.50 |
| 96160 |
|
84 |
80 |
$229.97 |
| 2015F |
|
12 |
12 |
$220.00 |
| 94760 |
|
130 |
122 |
$211.12 |
| 99058 |
|
21 |
21 |
$161.00 |
| 96161 |
|
55 |
49 |
$143.13 |
| 99188 |
|
90 |
85 |
$78.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
273 |
264 |
$60.00 |