| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,814 |
2,791 |
$288K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,406 |
1,954 |
$268K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,794 |
1,196 |
$124K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,280 |
999 |
$97K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
658 |
569 |
$34K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,183 |
598 |
$20K |
| 90648 |
|
1,761 |
1,105 |
$16K |
| 90686 |
|
1,342 |
890 |
$14K |
| 90670 |
|
1,557 |
985 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
140 |
95 |
$11K |
| 83655 |
|
698 |
317 |
$9K |
| 87428 |
|
115 |
110 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
254 |
117 |
$8K |
| 90723 |
|
888 |
583 |
$7K |
| 90633 |
|
693 |
328 |
$6K |
| 90677 |
|
131 |
122 |
$3K |
| 85018 |
|
1,039 |
521 |
$3K |
| D1206 |
Topical application of fluoride varnish |
91 |
66 |
$2K |
| 90656 |
|
108 |
105 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
100 |
62 |
$2K |
| 90710 |
|
102 |
62 |
$1K |
| 90696 |
|
100 |
60 |
$1K |
| 0071A |
|
26 |
26 |
$1K |
| 36416 |
|
342 |
173 |
$1K |
| 90681 |
|
152 |
107 |
$969.97 |
| 0072A |
|
13 |
13 |
$578.14 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
12 |
$463.88 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
13 |
13 |
$286.90 |
| 90700 |
|
36 |
12 |
$247.54 |
| 96127 |
|
16 |
13 |
$212.58 |
| 87807 |
|
16 |
15 |
$158.06 |
| 90688 |
|
13 |
13 |
$93.88 |