| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,349 |
6,917 |
$723K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,808 |
1,741 |
$190K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,611 |
1,537 |
$186K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,069 |
1,042 |
$114K |
| 92552 |
|
3,508 |
3,371 |
$85K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
581 |
525 |
$57K |
| 90686 |
|
1,553 |
1,474 |
$34K |
| D1206 |
Topical application of fluoride varnish |
1,200 |
1,198 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
111 |
97 |
$15K |
| 90648 |
|
447 |
440 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,136 |
1,098 |
$10K |
| 90734 |
|
442 |
406 |
$10K |
| 90651 |
|
414 |
401 |
$9K |
| 99173 |
|
3,519 |
3,388 |
$9K |
| 90670 |
|
382 |
377 |
$9K |
| 90685 |
|
182 |
179 |
$4K |
| 97803 |
|
212 |
209 |
$3K |
| 90649 |
|
109 |
107 |
$2K |
| 90621 |
|
93 |
92 |
$2K |
| 90716 |
|
87 |
87 |
$2K |
| 90700 |
|
82 |
81 |
$2K |
| 90723 |
|
83 |
81 |
$2K |
| 90707 |
|
80 |
80 |
$2K |
| 90633 |
|
80 |
78 |
$2K |
| 90715 |
|
58 |
58 |
$1K |
| 90672 |
|
51 |
50 |
$1K |
| 90680 |
|
39 |
38 |
$884.64 |
| 90677 |
|
15 |
13 |
$350.92 |
| 99051 |
|
15 |
13 |
$150.00 |