| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,513 |
1,286 |
$124K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,295 |
1,133 |
$79K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,616 |
1,474 |
$63K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
523 |
518 |
$53K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,205 |
2,008 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
281 |
256 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,956 |
1,778 |
$17K |
| 99199 |
Unlisted special service, procedure or report |
3,516 |
3,466 |
$10K |
| D0145 |
Oral evaluation for a patient under three years of age |
106 |
102 |
$4K |
| 96161 |
|
559 |
492 |
$2K |
| D1206 |
Topical application of fluoride varnish |
106 |
102 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40 |
30 |
$1K |
| 92551 |
|
466 |
432 |
$1K |
| 99383 |
|
21 |
14 |
$1K |
| 90474 |
|
16 |
16 |
$245.40 |
| 90670 |
|
527 |
477 |
$239.74 |
| 90723 |
|
488 |
450 |
$91.55 |
| 99173 |
|
263 |
238 |
$90.70 |
| 96127 |
|
18 |
16 |
$68.54 |
| 90686 |
|
293 |
277 |
$0.01 |
| 90680 |
|
257 |
234 |
$0.00 |
| 90647 |
|
422 |
391 |
$0.00 |
| 90633 |
|
91 |
87 |
$0.00 |
| 90681 |
|
16 |
16 |
$0.00 |