| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,658 |
5,083 |
$67K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,000 |
947 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
245 |
225 |
$8K |
| 0012A |
|
193 |
185 |
$8K |
| 96127 |
|
433 |
429 |
$6K |
| H1000 |
Prenatal care, at-risk assessment |
389 |
376 |
$6K |
| 90734 |
|
475 |
415 |
$4K |
| 36416 |
|
924 |
854 |
$4K |
| 0011A |
|
121 |
111 |
$2K |
| 90715 |
|
251 |
224 |
$2K |
| 90670 |
|
260 |
246 |
$2K |
| 90686 |
|
212 |
203 |
$2K |
| 90619 |
|
108 |
101 |
$2K |
| D1206 |
Topical application of fluoride varnish |
62 |
62 |
$2K |
| 0064A |
|
37 |
37 |
$2K |
| 0031A |
|
34 |
34 |
$1K |
| 90723 |
|
174 |
139 |
$1K |
| 96160 |
|
74 |
73 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$900.20 |
| 90647 |
|
104 |
93 |
$819.60 |
| 90710 |
|
64 |
57 |
$819.14 |
| 90651 |
|
26 |
24 |
$804.93 |
| 90696 |
|
71 |
66 |
$606.32 |
| 96111 |
|
32 |
32 |
$514.24 |
| 0002A |
|
12 |
12 |
$505.68 |
| 90716 |
|
17 |
17 |
$353.72 |
| 90707 |
|
16 |
16 |
$248.36 |
| 90677 |
|
13 |
13 |
$217.23 |
| 90681 |
|
26 |
25 |
$166.40 |
| 90698 |
|
27 |
12 |
$121.60 |
| 90633 |
|
16 |
16 |
$102.40 |
| 90700 |
|
16 |
14 |
$102.40 |