| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,719 |
2,128 |
$122K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
787 |
671 |
$61K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
741 |
641 |
$51K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
295 |
279 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
239 |
212 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
94 |
92 |
$8K |
| 90686 |
|
706 |
602 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
318 |
263 |
$5K |
| 90670 |
|
633 |
557 |
$5K |
| 90648 |
|
627 |
530 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
133 |
95 |
$3K |
| 90723 |
|
421 |
352 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
114 |
79 |
$3K |
| 90680 |
|
348 |
294 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
148 |
137 |
$2K |
| 90710 |
|
67 |
67 |
$2K |
| 90633 |
|
277 |
212 |
$2K |
| 85018 |
|
723 |
624 |
$2K |
| D1206 |
Topical application of fluoride varnish |
54 |
42 |
$1K |
| 90651 |
|
40 |
39 |
$1K |
| 90734 |
|
21 |
20 |
$508.20 |
| 90696 |
|
12 |
12 |
$228.90 |
| 90716 |
|
13 |
13 |
$205.22 |