| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,561 |
3,873 |
$376K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,071 |
1,025 |
$110K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,014 |
886 |
$96K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
787 |
750 |
$79K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
839 |
753 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
277 |
254 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
218 |
212 |
$24K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
437 |
384 |
$18K |
| 92587 |
|
1,589 |
1,516 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,473 |
1,335 |
$16K |
| 90686 |
|
690 |
665 |
$14K |
| 87428 |
|
468 |
428 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,225 |
1,172 |
$13K |
| 90698 |
|
527 |
476 |
$11K |
| 90670 |
|
494 |
450 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
335 |
158 |
$3K |
| 90656 |
|
113 |
105 |
$2K |
| 96127 |
|
283 |
274 |
$2K |
| 90680 |
|
94 |
85 |
$2K |
| 90633 |
|
83 |
74 |
$2K |
| 99177 |
|
470 |
455 |
$2K |
| 99173 |
|
608 |
589 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,385 |
2,196 |
$2K |
| 0072A |
|
38 |
37 |
$1K |
| 0071A |
|
36 |
35 |
$1K |
| 90677 |
|
25 |
25 |
$1K |
| D1206 |
Topical application of fluoride varnish |
31 |
31 |
$772.52 |
| 90461 |
|
969 |
906 |
$617.55 |
| 90619 |
|
14 |
14 |
$445.34 |
| 96161 |
|
171 |
155 |
$306.86 |
| 87807 |
|
27 |
25 |
$306.02 |
| 90744 |
|
12 |
12 |
$256.08 |
| 96160 |
|
58 |
57 |
$218.83 |
| 83655 |
|
12 |
12 |
$47.56 |
| 94760 |
|
17 |
14 |
$10.40 |
| 91307 |
|
77 |
70 |
$3.00 |
| 36416 |
|
91 |
82 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
71 |
71 |
$0.00 |