| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,074 |
1,899 |
$165K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,608 |
1,475 |
$142K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,127 |
2,000 |
$128K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,024 |
957 |
$94K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
847 |
789 |
$74K |
| 90686 |
|
2,663 |
2,283 |
$39K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
831 |
779 |
$38K |
| 99460 |
|
605 |
577 |
$35K |
| 90670 |
|
1,311 |
1,198 |
$22K |
| 96160 |
|
1,227 |
1,101 |
$18K |
| 90723 |
|
1,070 |
972 |
$17K |
| 90680 |
|
890 |
818 |
$14K |
| 90647 |
|
953 |
885 |
$14K |
| 96127 |
|
813 |
716 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
111 |
98 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
431 |
386 |
$9K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
68 |
54 |
$4K |
| 90633 |
|
187 |
170 |
$3K |
| 90677 |
|
119 |
101 |
$2K |
| 91321 |
|
106 |
74 |
$2K |
| 90656 |
|
121 |
120 |
$2K |
| 0081A |
|
41 |
39 |
$2K |
| 0071A |
|
31 |
29 |
$1K |
| 0154A |
|
19 |
14 |
$808.48 |
| 0002A |
|
16 |
15 |
$685.16 |
| 83655 |
|
39 |
39 |
$522.83 |
| 99462 |
|
19 |
12 |
$516.43 |
| 0124A |
|
12 |
12 |
$509.16 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$431.60 |
| 90651 |
|
29 |
26 |
$346.03 |
| 90681 |
|
16 |
13 |
$269.34 |
| 90716 |
|
13 |
13 |
$250.60 |
| 90707 |
|
13 |
13 |
$250.60 |
| 90710 |
|
12 |
12 |
$225.60 |
| 90700 |
|
12 |
12 |
$164.55 |
| 90734 |
|
14 |
14 |
$91.42 |
| 36415 |
Collection of venous blood by venipuncture |
115 |
107 |
$0.00 |