| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,497 |
2,063 |
$112K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
580 |
521 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
542 |
452 |
$40K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
226 |
212 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
411 |
371 |
$10K |
| 96127 |
|
526 |
481 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
327 |
149 |
$6K |
| 90686 |
|
345 |
298 |
$3K |
| 90734 |
|
72 |
55 |
$3K |
| 83655 |
|
224 |
182 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
35 |
34 |
$2K |
| D1206 |
Topical application of fluoride varnish |
75 |
66 |
$2K |
| 99173 |
|
281 |
254 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
81 |
56 |
$1K |
| 90715 |
|
68 |
57 |
$1K |
| 90707 |
|
69 |
52 |
$937.60 |
| 90670 |
|
50 |
46 |
$740.44 |
| 85018 |
|
286 |
235 |
$656.56 |
| 90716 |
|
32 |
28 |
$579.02 |
| 90651 |
|
16 |
14 |
$512.14 |
| 90648 |
|
49 |
45 |
$346.16 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
22 |
21 |
$283.36 |
| 90723 |
|
28 |
27 |
$258.35 |
| 90633 |
|
14 |
14 |
$186.55 |
| 90685 |
|
21 |
15 |
$178.02 |
| 90681 |
|
18 |
17 |
$115.20 |