| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,472 |
5,241 |
$653K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,949 |
5,080 |
$537K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
786 |
759 |
$86K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
602 |
594 |
$73K |
| 90686 |
|
1,277 |
1,259 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
234 |
234 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,054 |
1,024 |
$11K |
| D1206 |
Topical application of fluoride varnish |
304 |
297 |
$7K |
| 90656 |
|
250 |
248 |
$6K |
| 99173 |
|
1,991 |
1,944 |
$5K |
| 90685 |
|
119 |
116 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
223 |
202 |
$3K |
| 0071A |
|
47 |
45 |
$2K |
| 0072A |
|
38 |
37 |
$1K |
| 90619 |
|
31 |
31 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 99050 |
|
77 |
76 |
$948.51 |
| 90620 |
|
37 |
37 |
$861.36 |
| 90734 |
|
25 |
25 |
$582.00 |
| 90744 |
|
16 |
16 |
$372.48 |
| 90633 |
|
14 |
14 |
$325.92 |
| 90648 |
|
15 |
13 |
$302.64 |
| 90670 |
|
12 |
12 |
$279.36 |
| 90651 |
|
12 |
12 |
$279.36 |
| 99401 |
|
278 |
233 |
$197.90 |
| 99072 |
|
1,022 |
884 |
$46.56 |
| 91307 |
|
62 |
55 |
$0.06 |