| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,685 |
2,651 |
$288K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,122 |
4,815 |
$287K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,616 |
2,612 |
$281K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
990 |
989 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
657 |
625 |
$57K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
560 |
549 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
263 |
263 |
$28K |
| 92551 |
|
2,410 |
2,407 |
$28K |
| 90686 |
|
2,162 |
2,150 |
$12K |
| 90697 |
|
571 |
570 |
$10K |
| 90671 |
|
898 |
884 |
$9K |
| 90698 |
|
474 |
474 |
$7K |
| 90670 |
|
1,327 |
1,326 |
$7K |
| 90680 |
|
1,097 |
1,090 |
$6K |
| D1206 |
Topical application of fluoride varnish |
159 |
159 |
$4K |
| 99381 |
|
24 |
24 |
$2K |
| 99188 |
|
117 |
117 |
$2K |
| 90656 |
|
211 |
208 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
13 |
12 |
$1K |
| 90480 |
|
27 |
25 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
39 |
$1K |
| 90633 |
|
172 |
172 |
$946.57 |
| 90744 |
|
171 |
171 |
$871.41 |
| 99072 |
|
34 |
32 |
$464.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
26 |
$452.02 |
| 96161 |
|
117 |
117 |
$303.81 |
| 90707 |
|
25 |
25 |
$262.90 |
| 99173 |
|
38 |
37 |
$94.20 |
| 90648 |
|
12 |
12 |
$66.49 |