| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,158 |
2,331 |
$266K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,158 |
2,430 |
$220K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,657 |
1,940 |
$203K |
| 96127 |
|
3,807 |
2,896 |
$53K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
637 |
544 |
$49K |
| 90670 |
|
2,199 |
1,639 |
$45K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,176 |
1,637 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
222 |
152 |
$26K |
| 90677 |
|
413 |
332 |
$23K |
| 90723 |
|
1,942 |
1,436 |
$20K |
| 90647 |
|
1,857 |
1,335 |
$19K |
| 90686 |
|
1,171 |
853 |
$15K |
| 90680 |
|
1,303 |
973 |
$13K |
| 83655 |
|
1,006 |
724 |
$13K |
| 90633 |
|
1,039 |
744 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
69 |
58 |
$6K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
383 |
348 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
174 |
123 |
$5K |
| 90697 |
|
188 |
158 |
$3K |
| 85018 |
|
1,140 |
813 |
$3K |
| 36416 |
|
704 |
468 |
$3K |
| 92551 |
|
94 |
68 |
$1K |
| D1206 |
Topical application of fluoride varnish |
55 |
37 |
$1K |
| 90716 |
|
93 |
67 |
$1K |
| 90651 |
|
49 |
43 |
$1K |
| 90656 |
|
42 |
39 |
$705.75 |
| 90696 |
|
53 |
39 |
$645.39 |
| 90700 |
|
70 |
43 |
$568.02 |
| 90710 |
|
32 |
27 |
$526.42 |
| 90707 |
|
60 |
39 |
$465.12 |
| 90734 |
|
20 |
15 |
$300.89 |
| 90681 |
|
17 |
14 |
$284.07 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
13 |
13 |
$189.80 |
| 88720 |
|
13 |
12 |
$57.20 |