| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,159 |
3,542 |
$124K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
909 |
893 |
$84K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
953 |
936 |
$75K |
| 99051 |
|
855 |
805 |
$64K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
751 |
700 |
$58K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
820 |
748 |
$55K |
| 96150 |
|
1,560 |
1,489 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
490 |
393 |
$33K |
| 92551 |
|
1,472 |
1,449 |
$20K |
| 90658 |
|
941 |
923 |
$18K |
| 92015 |
Determination of refractive state |
1,386 |
1,365 |
$14K |
| 90648 |
|
465 |
388 |
$9K |
| 99215 |
Prolong outpt/office vis |
88 |
86 |
$9K |
| D1206 |
Topical application of fluoride varnish |
378 |
373 |
$8K |
| 90670 |
|
427 |
361 |
$8K |
| 90649 |
|
290 |
289 |
$5K |
| 90723 |
|
237 |
189 |
$5K |
| 85014 |
|
1,582 |
1,540 |
$4K |
| 81000 |
|
1,293 |
1,274 |
$4K |
| 90655 |
|
214 |
192 |
$4K |
| 96156 |
|
14 |
14 |
$1K |
| 90681 |
|
68 |
55 |
$1K |
| 90734 |
|
58 |
58 |
$1K |
| 90633 |
|
59 |
57 |
$1K |
| 90707 |
|
60 |
59 |
$1K |
| 90716 |
|
55 |
55 |
$1K |
| 90620 |
|
45 |
45 |
$779.00 |
| 97802 |
|
17 |
17 |
$515.95 |
| 96127 |
|
15 |
15 |
$88.80 |