| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,036 |
1,944 |
$135K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
876 |
831 |
$84K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
760 |
741 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
154 |
151 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
513 |
501 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
80 |
77 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
91 |
86 |
$7K |
| D0190 |
|
305 |
299 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
36 |
$4K |
| D1206 |
Topical application of fluoride varnish |
64 |
63 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
71 |
69 |
$797.61 |
| D0145 |
Oral evaluation for a patient under three years of age |
24 |
24 |
$743.43 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$519.74 |
| 99173 |
|
72 |
71 |
$398.47 |
| 3074F |
|
2,065 |
1,930 |
$0.00 |
| 99070 |
|
14 |
14 |
$0.00 |
| 90686 |
|
200 |
195 |
$0.00 |
| 90656 |
|
21 |
21 |
$0.00 |
| 99000 |
|
13 |
13 |
$0.00 |
| 1159F |
|
1,121 |
1,068 |
$0.00 |
| 3078F |
|
2,036 |
1,901 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
564 |
547 |
$0.00 |
| 90461 |
|
177 |
175 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |