| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,116 |
1,818 |
$103K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
815 |
740 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
713 |
585 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
459 |
390 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
166 |
152 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
114 |
69 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
385 |
333 |
$6K |
| 96127 |
|
418 |
323 |
$6K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
43 |
43 |
$1K |
| D1206 |
Topical application of fluoride varnish |
42 |
41 |
$1K |
| 99173 |
|
12 |
12 |
$89.40 |