| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
294 |
260 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
143 |
119 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
29 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
121 |
114 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
14 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
199 |
184 |
$750.46 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
19 |
15 |
$741.89 |
| 85018 |
|
229 |
196 |
$409.41 |
| 3008F |
|
44 |
41 |
$360.00 |
| 83655 |
|
38 |
31 |
$321.82 |
| 99173 |
|
14 |
14 |
$228.00 |
| 36416 |
|
151 |
140 |
$206.04 |
| 92551 |
|
14 |
14 |
$76.14 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
12 |
$67.56 |
| 90658 |
|
14 |
14 |
$43.03 |
| 86580 |
|
12 |
12 |
$42.91 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
87 |
76 |
$0.00 |