| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,044 |
968 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
404 |
325 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
232 |
174 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
207 |
162 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
638 |
495 |
$11K |
| 96127 |
|
539 |
446 |
$8K |
| 87428 |
|
127 |
124 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
99 |
90 |
$7K |
| D1206 |
Topical application of fluoride varnish |
113 |
74 |
$3K |
| 90686 |
|
108 |
96 |
$2K |
| 90656 |
|
88 |
76 |
$1K |
| 90671 |
|
65 |
55 |
$1K |
| 90697 |
|
61 |
51 |
$1K |
| 90680 |
|
49 |
39 |
$818.79 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
36 |
30 |
$538.51 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
34 |
27 |
$407.70 |
| 83655 |
|
28 |
25 |
$321.79 |
| 85018 |
|
60 |
51 |
$136.88 |
| 36416 |
|
33 |
27 |
$135.30 |
| 81002 |
|
14 |
13 |
$36.40 |