| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,273 |
2,255 |
$256K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,021 |
2,542 |
$210K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,681 |
2,391 |
$132K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,663 |
1,343 |
$122K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,357 |
1,149 |
$106K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,544 |
2,422 |
$59K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
405 |
312 |
$35K |
| 96127 |
|
1,050 |
861 |
$16K |
| 99173 |
|
617 |
508 |
$5K |
| 92587 |
|
366 |
290 |
$4K |
| 99460 |
|
37 |
33 |
$2K |
| D1206 |
Topical application of fluoride varnish |
70 |
62 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
28 |
26 |
$968.02 |