| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,740 |
4,800 |
$277K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,209 |
1,022 |
$90K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,096 |
874 |
$83K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
786 |
656 |
$64K |
| 96127 |
|
1,987 |
1,763 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
374 |
280 |
$26K |
| 99173 |
|
2,246 |
1,998 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
767 |
576 |
$12K |
| 90686 |
|
1,073 |
959 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
57 |
54 |
$5K |
| 90698 |
|
401 |
290 |
$4K |
| 90651 |
|
69 |
57 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
121 |
111 |
$3K |
| 90734 |
|
175 |
134 |
$3K |
| 90670 |
|
289 |
215 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,407 |
1,100 |
$2K |
| 90656 |
|
130 |
125 |
$2K |
| D1206 |
Topical application of fluoride varnish |
61 |
44 |
$2K |
| 99383 |
|
16 |
15 |
$2K |
| 90461 |
|
352 |
214 |
$585.05 |
| 90716 |
|
45 |
40 |
$535.16 |
| 90707 |
|
45 |
39 |
$417.05 |
| 90715 |
|
19 |
13 |
$317.49 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$187.80 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$180.32 |
| 90649 |
|
18 |
14 |
$114.00 |
| 90633 |
|
12 |
12 |
$76.80 |
| 99072 |
|
13 |
13 |
$0.00 |