| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,989 |
1,650 |
$138K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
474 |
453 |
$49K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
365 |
365 |
$39K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
359 |
359 |
$38K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
298 |
297 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
301 |
290 |
$30K |
| 90686 |
|
983 |
972 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
466 |
379 |
$21K |
| 97803 |
|
399 |
386 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,102 |
776 |
$10K |
| 92551 |
|
940 |
873 |
$9K |
| 90670 |
|
226 |
226 |
$5K |
| 90698 |
|
225 |
225 |
$5K |
| 90651 |
|
155 |
154 |
$4K |
| 99401 |
|
886 |
676 |
$3K |
| 90633 |
|
133 |
133 |
$3K |
| 90744 |
|
128 |
128 |
$3K |
| 90734 |
|
116 |
114 |
$3K |
| 99215 |
Prolong outpt/office vis |
17 |
17 |
$3K |
| 99173 |
|
942 |
872 |
$2K |
| 90681 |
|
95 |
95 |
$2K |
| D1206 |
Topical application of fluoride varnish |
90 |
90 |
$2K |
| 96127 |
|
443 |
440 |
$2K |
| 90710 |
|
81 |
81 |
$2K |
| W7000 |
|
357 |
353 |
$2K |
| 90696 |
|
57 |
57 |
$1K |
| 94060 |
|
17 |
16 |
$804.25 |
| 90716 |
|
26 |
26 |
$605.28 |
| 90715 |
|
22 |
22 |
$512.16 |
| 96161 |
|
194 |
177 |
$479.85 |
| 90621 |
|
16 |
16 |
$464.61 |
| 99051 |
|
40 |
40 |
$380.00 |
| 96160 |
|
144 |
141 |
$376.72 |
| 90707 |
|
14 |
14 |
$325.92 |
| 81002 |
|
117 |
113 |
$313.01 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
299 |
143 |
$71.25 |
| 99000 |
|
78 |
58 |
$1.00 |
| 90461 |
|
16 |
15 |
$0.00 |
| 99072 |
|
105 |
104 |
$0.00 |