| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,094 |
1,864 |
$163K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,836 |
1,620 |
$123K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,275 |
1,178 |
$81K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
732 |
645 |
$59K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
389 |
358 |
$33K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
122 |
111 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
77 |
68 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
342 |
279 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
32 |
$3K |
| 96127 |
|
181 |
164 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
51 |
51 |
$1K |
| D1206 |
Topical application of fluoride varnish |
37 |
29 |
$936.00 |
| 99173 |
|
17 |
17 |
$126.65 |