| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,511 |
16,417 |
$1.54M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,142 |
3,988 |
$474K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,337 |
3,175 |
$346K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,091 |
1,992 |
$215K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,213 |
1,133 |
$136K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,372 |
1,255 |
$125K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,916 |
1,830 |
$100K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
8,511 |
8,164 |
$73K |
| 90688 |
|
1,218 |
1,152 |
$26K |
| 90686 |
|
1,113 |
1,093 |
$25K |
| 90734 |
|
1,049 |
1,027 |
$23K |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,260 |
2,176 |
$19K |
| 90670 |
|
887 |
848 |
$19K |
| 0071A |
|
388 |
347 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
104 |
101 |
$11K |
| 90698 |
|
480 |
459 |
$10K |
| 90715 |
|
361 |
354 |
$8K |
| 90649 |
|
544 |
527 |
$7K |
| 90633 |
|
332 |
324 |
$7K |
| 90685 |
|
293 |
277 |
$6K |
| 90680 |
|
281 |
267 |
$6K |
| 90621 |
|
217 |
204 |
$5K |
| 90697 |
|
226 |
213 |
$5K |
| D1206 |
Topical application of fluoride varnish |
164 |
164 |
$4K |
| 90648 |
|
193 |
177 |
$4K |
| 90710 |
|
181 |
178 |
$4K |
| 90723 |
|
167 |
151 |
$3K |
| 90707 |
|
53 |
53 |
$1K |
| 90696 |
|
59 |
56 |
$1K |
| 90716 |
|
48 |
46 |
$1K |
| 90744 |
|
52 |
43 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
54 |
43 |
$876.16 |
| 90700 |
|
13 |
12 |
$186.24 |
| 87430 |
|
39 |
36 |
$93.52 |
| 99173 |
|
26 |
25 |
$65.26 |
| 91307 |
|
242 |
220 |
$24.00 |
| 99421 |
|
34 |
34 |
$0.00 |