| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,221 |
7,583 |
$702K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,676 |
3,023 |
$331K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,204 |
2,783 |
$306K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,715 |
2,293 |
$276K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,288 |
2,045 |
$208K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,375 |
1,222 |
$157K |
| 92587 |
|
5,693 |
4,126 |
$69K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,059 |
899 |
$51K |
| 90658 |
|
2,195 |
1,884 |
$43K |
| 90698 |
|
1,918 |
1,731 |
$39K |
| 90670 |
|
1,863 |
1,694 |
$38K |
| 90651 |
|
1,608 |
1,361 |
$32K |
| D1206 |
Topical application of fluoride varnish |
1,164 |
1,114 |
$28K |
| 90680 |
|
1,310 |
1,197 |
$27K |
| 90633 |
|
1,216 |
1,085 |
$25K |
| 90734 |
|
1,187 |
994 |
$23K |
| 90744 |
|
1,069 |
957 |
$22K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
975 |
866 |
$21K |
| 99173 |
|
7,820 |
6,500 |
$17K |
| 99463 |
|
131 |
129 |
$14K |
| 90715 |
|
690 |
560 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
103 |
79 |
$10K |
| 90677 |
|
112 |
107 |
$8K |
| 90621 |
|
416 |
366 |
$8K |
| 90710 |
|
413 |
352 |
$8K |
| 90696 |
|
342 |
285 |
$7K |
| 90657 |
|
311 |
286 |
$6K |
| 90697 |
|
94 |
90 |
$4K |
| 99381 |
|
43 |
39 |
$4K |
| 99051 |
|
502 |
398 |
$4K |
| 90716 |
|
167 |
143 |
$4K |
| 90707 |
|
126 |
101 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
15 |
$2K |
| 96127 |
|
291 |
276 |
$1K |
| 99383 |
|
17 |
13 |
$1K |