| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,074 |
1,770 |
$172K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,006 |
2,336 |
$145K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
979 |
782 |
$83K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
628 |
541 |
$50K |
| 96127 |
|
1,672 |
1,416 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
256 |
203 |
$23K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
287 |
232 |
$22K |
| 90686 |
|
1,921 |
1,545 |
$19K |
| D1206 |
Topical application of fluoride varnish |
187 |
151 |
$5K |
| 96160 |
|
362 |
323 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
194 |
172 |
$4K |
| 90670 |
|
222 |
175 |
$3K |
| 91321 |
|
70 |
63 |
$3K |
| 90656 |
|
107 |
105 |
$2K |
| 90698 |
|
63 |
56 |
$868.16 |
| 90651 |
|
41 |
37 |
$684.33 |
| 99173 |
|
79 |
65 |
$622.73 |
| 0124A |
|
14 |
13 |
$610.28 |
| 91322 |
|
16 |
12 |
$597.32 |
| 0072A |
|
13 |
12 |
$577.29 |
| 90734 |
|
30 |
25 |
$375.84 |
| 90685 |
|
60 |
51 |
$364.80 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
22 |
18 |
$294.95 |
| 85018 |
|
115 |
100 |
$267.66 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
60 |
54 |
$263.92 |
| 90710 |
|
12 |
12 |
$200.23 |
| 90680 |
|
13 |
13 |
$172.10 |
| 36416 |
|
26 |
26 |
$112.75 |
| 99174 |
|
15 |
13 |
$111.05 |
| 91307 |
|
13 |
12 |
$0.04 |