| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,678 |
2,906 |
$281K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,547 |
2,882 |
$242K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,114 |
1,919 |
$157K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,914 |
2,641 |
$137K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,659 |
3,871 |
$91K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
937 |
870 |
$70K |
| 90670 |
|
2,643 |
2,048 |
$49K |
| 96127 |
|
2,533 |
2,273 |
$39K |
| 90677 |
|
458 |
418 |
$28K |
| 90723 |
|
1,796 |
1,418 |
$21K |
| 83655 |
|
1,692 |
1,315 |
$20K |
| 99215 |
Prolong outpt/office vis |
313 |
262 |
$20K |
| 90647 |
|
1,770 |
1,387 |
$19K |
| 90680 |
|
1,589 |
1,246 |
$18K |
| D1206 |
Topical application of fluoride varnish |
652 |
470 |
$17K |
| 90686 |
|
1,653 |
1,387 |
$17K |
| 90633 |
|
1,551 |
1,218 |
$15K |
| 90698 |
|
764 |
592 |
$7K |
| 99381 |
|
84 |
77 |
$7K |
| 96160 |
|
393 |
364 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
51 |
$4K |
| 90716 |
|
271 |
202 |
$4K |
| 85018 |
|
1,642 |
1,280 |
$4K |
| 90681 |
|
289 |
235 |
$3K |
| 90707 |
|
285 |
207 |
$3K |
| 90744 |
|
336 |
279 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
169 |
161 |
$2K |
| 90656 |
|
114 |
110 |
$2K |
| 90700 |
|
208 |
150 |
$2K |
| 90710 |
|
66 |
62 |
$537.23 |
| 90696 |
|
66 |
62 |
$537.23 |
| 90651 |
|
14 |
12 |
$527.22 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
86 |
76 |
$493.64 |
| 36415 |
Collection of venous blood by venipuncture |
88 |
76 |
$295.20 |
| 90381 |
|
16 |
14 |
$267.36 |
| 90685 |
|
27 |
20 |
$194.00 |
| 99173 |
|
21 |
16 |
$156.45 |
| 90461 |
|
19 |
19 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
65 |
55 |
$0.00 |