| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,583 |
1,907 |
$202K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,592 |
2,256 |
$180K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,702 |
2,327 |
$131K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,168 |
1,003 |
$91K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
794 |
650 |
$59K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
442 |
328 |
$39K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,289 |
1,680 |
$38K |
| 96127 |
|
1,160 |
923 |
$17K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
109 |
92 |
$5K |
| 99173 |
|
466 |
376 |
$4K |
| 92587 |
|
180 |
159 |
$2K |
| D1206 |
Topical application of fluoride varnish |
38 |
33 |
$1K |
| 99460 |
|
14 |
14 |
$878.64 |