| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,817 |
3,271 |
$472K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,733 |
1,620 |
$148K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,357 |
2,302 |
$69K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
484 |
473 |
$52K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
226 |
223 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
246 |
242 |
$26K |
| D1206 |
Topical application of fluoride varnish |
990 |
975 |
$24K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,486 |
1,459 |
$16K |
| 92551 |
|
1,596 |
1,561 |
$15K |
| 90686 |
|
485 |
468 |
$11K |
| 96127 |
|
1,700 |
1,639 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
65 |
64 |
$6K |
| 99173 |
|
1,594 |
1,559 |
$4K |
| 90670 |
|
51 |
49 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
53 |
44 |
$1K |
| 90656 |
|
43 |
43 |
$977.76 |
| 90648 |
|
39 |
39 |
$907.92 |
| 96160 |
|
225 |
223 |
$606.63 |
| 96161 |
|
96 |
93 |
$254.84 |
| 99072 |
|
341 |
309 |
$48.00 |