| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,081 |
2,728 |
$217K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,272 |
2,939 |
$152K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,714 |
1,518 |
$128K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,577 |
1,286 |
$105K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
662 |
604 |
$48K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
452 |
404 |
$35K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,445 |
1,289 |
$26K |
| 96127 |
|
1,025 |
864 |
$17K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
94 |
88 |
$13K |
| 90670 |
|
789 |
679 |
$7K |
| 90723 |
|
397 |
314 |
$2K |
| 90647 |
|
365 |
281 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
103 |
64 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
35 |
30 |
$1K |
| 90686 |
|
205 |
171 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
86 |
66 |
$1K |
| D1206 |
Topical application of fluoride varnish |
31 |
31 |
$806.00 |
| 90734 |
|
101 |
78 |
$722.18 |
| 90680 |
|
88 |
68 |
$514.95 |
| 90633 |
|
101 |
79 |
$505.18 |
| 90677 |
|
54 |
51 |
$332.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$286.31 |
| 92551 |
|
16 |
16 |
$212.80 |
| 90688 |
|
23 |
15 |
$147.20 |
| 90715 |
|
17 |
15 |
$128.05 |
| 87807 |
|
20 |
15 |
$110.66 |
| 90651 |
|
14 |
12 |
$70.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
16 |
$0.00 |