| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,642 |
4,126 |
$29K |
| D0191 |
|
982 |
908 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,197 |
1,073 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,331 |
1,237 |
$5K |
| D1206 |
Topical application of fluoride varnish |
124 |
99 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
411 |
394 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
275 |
248 |
$199.66 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,337 |
2,189 |
$178.75 |
| 90670 |
|
633 |
596 |
$131.76 |
| 90686 |
|
286 |
285 |
$47.04 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
65 |
63 |
$43.51 |
| 90685 |
|
44 |
43 |
$30.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
26 |
$23.14 |
| 96160 |
|
148 |
118 |
$22.00 |
| 90672 |
|
137 |
134 |
$10.21 |
| 85018 |
|
68 |
63 |
$0.00 |
| 90723 |
|
83 |
80 |
$0.00 |
| 90647 |
|
331 |
305 |
$0.00 |
| 90660 |
|
13 |
12 |
$0.00 |
| 90680 |
|
59 |
57 |
$0.00 |
| 90651 |
|
66 |
65 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
19 |
17 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90700 |
|
15 |
14 |
$0.00 |
| 90633 |
|
102 |
86 |
$0.00 |
| 90710 |
|
25 |
25 |
$0.00 |
| 83655 |
|
70 |
65 |
$0.00 |
| 90734 |
|
25 |
24 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
51 |
43 |
$0.00 |
| 90681 |
|
24 |
24 |
$0.00 |