| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,930 |
3,496 |
$186K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,811 |
1,482 |
$133K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,812 |
1,580 |
$122K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
810 |
670 |
$56K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
571 |
470 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
381 |
338 |
$26K |
| 90670 |
|
1,313 |
1,132 |
$14K |
| 99460 |
|
177 |
171 |
$10K |
| 90686 |
|
1,009 |
882 |
$10K |
| D1206 |
Topical application of fluoride varnish |
299 |
238 |
$8K |
| 90680 |
|
612 |
526 |
$6K |
| 90633 |
|
718 |
595 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
442 |
403 |
$6K |
| 90651 |
|
446 |
338 |
$5K |
| 90697 |
|
306 |
271 |
$5K |
| 90710 |
|
441 |
318 |
$4K |
| 90734 |
|
404 |
286 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
894 |
793 |
$4K |
| 90648 |
|
531 |
473 |
$4K |
| 90677 |
|
153 |
119 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
53 |
51 |
$2K |
| 90723 |
|
331 |
274 |
$2K |
| 90715 |
|
228 |
182 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
136 |
135 |
$2K |
| 90620 |
|
136 |
92 |
$2K |
| 99462 |
|
78 |
49 |
$2K |
| 90696 |
|
158 |
109 |
$1K |
| 90619 |
|
67 |
66 |
$1K |
| 99464 |
|
13 |
13 |
$1K |
| 90671 |
|
25 |
25 |
$560.95 |
| 90656 |
|
25 |
25 |
$417.75 |
| 90698 |
|
43 |
38 |
$270.08 |
| 90685 |
|
36 |
36 |
$224.00 |