| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,012 |
1,512 |
$158K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,955 |
1,616 |
$97K |
| 96127 |
|
1,996 |
1,489 |
$35K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
291 |
206 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
103 |
82 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
97 |
73 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
109 |
97 |
$6K |
| 90686 |
|
350 |
275 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
63 |
53 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
191 |
151 |
$3K |
| 0071A |
|
66 |
37 |
$3K |
| 90677 |
|
22 |
14 |
$3K |
| 0072A |
|
53 |
35 |
$2K |
| 90656 |
|
107 |
103 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
41 |
39 |
$971.10 |
| 87428 |
|
14 |
13 |
$890.26 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
63 |
33 |
$738.54 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
24 |
$530.62 |
| 92551 |
|
34 |
26 |
$527.44 |
| 36416 |
|
127 |
80 |
$523.63 |
| D1206 |
Topical application of fluoride varnish |
17 |
14 |
$442.00 |
| 90651 |
|
20 |
12 |
$251.20 |
| 90648 |
|
12 |
12 |
$200.52 |