| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,088 |
2,418 |
$273K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
613 |
592 |
$65K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
396 |
386 |
$47K |
| 90686 |
|
1,455 |
1,381 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
260 |
205 |
$30K |
| D1206 |
Topical application of fluoride varnish |
1,560 |
748 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
164 |
145 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,072 |
1,009 |
$9K |
| 90688 |
|
72 |
72 |
$2K |
| 96127 |
|
321 |
311 |
$1K |
| 90651 |
|
52 |
52 |
$1K |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
119 |
117 |
$1K |
| 90715 |
|
14 |
14 |
$351.68 |
| 90670 |
|
16 |
15 |
$349.20 |
| 90734 |
|
13 |
13 |
$279.36 |
| 90744 |
|
12 |
12 |
$256.08 |
| 99050 |
|
15 |
12 |
$223.52 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
181 |
179 |
$9.00 |