| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,561 |
2,408 |
$167K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,867 |
3,471 |
$119K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,111 |
965 |
$97K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
776 |
733 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
728 |
686 |
$59K |
| 90686 |
|
3,141 |
3,102 |
$50K |
| 92552 |
|
2,191 |
2,175 |
$47K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
446 |
446 |
$45K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
506 |
500 |
$43K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,468 |
2,171 |
$40K |
| 90671 |
|
150 |
130 |
$34K |
| 99215 |
Prolong outpt/office vis |
197 |
194 |
$21K |
| 99173 |
|
2,412 |
2,389 |
$10K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,161 |
1,150 |
$10K |
| 90480 |
|
239 |
239 |
$10K |
| 91320 |
|
90 |
89 |
$8K |
| D1206 |
Topical application of fluoride varnish |
323 |
309 |
$7K |
| 99051 |
|
103 |
93 |
$5K |
| 99188 |
|
205 |
187 |
$4K |
| 0124A |
|
99 |
99 |
$4K |
| 91319 |
|
57 |
56 |
$4K |
| 90670 |
|
143 |
138 |
$2K |
| 91318 |
|
30 |
30 |
$2K |
| 90680 |
|
90 |
84 |
$1K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
24 |
24 |
$1K |
| 90698 |
|
71 |
71 |
$884.20 |
| 99460 |
|
12 |
12 |
$747.72 |
| 81003 |
|
270 |
240 |
$741.69 |
| 96127 |
|
100 |
100 |
$586.18 |
| G9920 |
Screening performed and negative |
15 |
15 |
$535.05 |
| 0081A |
|
13 |
13 |
$520.00 |
| 0082A |
|
12 |
12 |
$480.00 |
| 0154A |
|
12 |
12 |
$480.00 |
| 90734 |
|
12 |
12 |
$449.31 |
| 90744 |
|
28 |
27 |
$421.21 |
| 99462 |
|
12 |
12 |
$386.04 |
| 90674 |
|
23 |
23 |
$273.54 |
| 85018 |
|
33 |
24 |
$85.80 |