| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,058 |
2,680 |
$253K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
848 |
808 |
$103K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
476 |
452 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
482 |
438 |
$47K |
| 99215 |
Prolong outpt/office vis |
228 |
215 |
$37K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
290 |
287 |
$31K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
503 |
470 |
$26K |
| 90688 |
|
707 |
682 |
$16K |
| D1206 |
Topical application of fluoride varnish |
563 |
563 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,461 |
1,385 |
$12K |
| 92551 |
|
1,037 |
1,000 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
78 |
77 |
$9K |
| 99460 |
|
63 |
58 |
$6K |
| 90670 |
|
229 |
222 |
$5K |
| 90648 |
|
186 |
181 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
47 |
45 |
$3K |
| 99173 |
|
869 |
840 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
47 |
47 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
13 |
12 |
$677.55 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
77 |
77 |
$644.00 |
| 90656 |
|
29 |
29 |
$582.00 |
| 0001A |
|
15 |
15 |
$444.00 |
| 90651 |
|
16 |
16 |
$372.48 |
| 90633 |
|
13 |
13 |
$302.64 |
| 90677 |
|
13 |
12 |
$279.36 |
| 90680 |
|
12 |
12 |
$279.36 |
| 99177 |
|
12 |
12 |
$59.20 |
| 91300 |
|
37 |
30 |
$0.00 |