| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,368 |
9,208 |
$617K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,356 |
4,164 |
$332K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,180 |
4,074 |
$313K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,558 |
2,282 |
$171K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,308 |
1,271 |
$114K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
910 |
864 |
$79K |
| D1206 |
Topical application of fluoride varnish |
2,728 |
2,686 |
$66K |
| 99233 |
Prolong inpt eval add15 m |
621 |
174 |
$47K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
488 |
200 |
$35K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
228 |
223 |
$25K |
| 99223 |
Prolong inpt eval add15 m |
63 |
61 |
$12K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
123 |
115 |
$8K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
89 |
46 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
212 |
201 |
$7K |
| 99381 |
|
74 |
71 |
$5K |
| 99222 |
Initial hospital care, per day, moderate complexity |
29 |
28 |
$4K |
| 99236 |
Prolong inpt eval add15 m |
29 |
12 |
$4K |
| 99215 |
Prolong outpt/office vis |
29 |
26 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
26 |
12 |
$675.60 |
| 3078F |
|
97 |
95 |
$0.00 |
| 3074F |
|
96 |
94 |
$0.00 |