| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
867 |
778 |
$68K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
979 |
827 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
432 |
304 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
373 |
302 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,197 |
966 |
$19K |
| 96127 |
|
341 |
291 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
59 |
59 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
45 |
44 |
$1K |
| D1206 |
Topical application of fluoride varnish |
19 |
15 |
$513.50 |
| 99460 |
|
12 |
12 |
$465.00 |
| 99173 |
|
24 |
23 |
$170.26 |
| 83655 |
|
12 |
12 |
$142.32 |
| 85018 |
|
12 |
12 |
$25.52 |