| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,268 |
1,081 |
$91K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
420 |
357 |
$46K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
117 |
113 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,297 |
1,164 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
119 |
110 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62 |
47 |
$5K |
| 90686 |
|
240 |
224 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44 |
39 |
$4K |
| 92552 |
|
155 |
145 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
57 |
53 |
$2K |
| 96127 |
|
471 |
429 |
$2K |
| 92551 |
|
234 |
213 |
$2K |
| 99173 |
|
765 |
693 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| D1206 |
Topical application of fluoride varnish |
41 |
40 |
$946.96 |
| 97803 |
|
36 |
28 |
$289.85 |
| 99408 |
|
14 |
14 |
$0.00 |