| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,402 |
4,203 |
$406K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,051 |
6,566 |
$389K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,264 |
2,550 |
$242K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,965 |
2,351 |
$198K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,582 |
4,514 |
$106K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,382 |
1,187 |
$100K |
| 96127 |
|
4,673 |
3,818 |
$83K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,085 |
1,567 |
$72K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
734 |
610 |
$57K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,869 |
1,507 |
$55K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,912 |
1,584 |
$31K |
| 96160 |
|
2,229 |
1,796 |
$31K |
| 90677 |
|
487 |
362 |
$30K |
| 90670 |
|
2,006 |
1,595 |
$23K |
| 90686 |
|
1,994 |
1,697 |
$20K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,102 |
928 |
$14K |
| 90648 |
|
1,601 |
1,270 |
$12K |
| 83655 |
|
919 |
720 |
$11K |
| 90697 |
|
628 |
459 |
$11K |
| 90633 |
|
950 |
730 |
$10K |
| 90723 |
|
1,171 |
938 |
$9K |
| 90681 |
|
761 |
585 |
$8K |
| D1206 |
Topical application of fluoride varnish |
258 |
219 |
$7K |
| 87807 |
|
511 |
390 |
$5K |
| 99381 |
|
55 |
44 |
$5K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
79 |
74 |
$4K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
26 |
25 |
$3K |
| 36416 |
|
717 |
604 |
$3K |
| 90734 |
|
190 |
133 |
$2K |
| 85018 |
|
858 |
678 |
$2K |
| 90656 |
|
109 |
106 |
$2K |
| 90651 |
|
131 |
96 |
$1K |
| 90619 |
|
79 |
66 |
$1K |
| 90696 |
|
101 |
71 |
$1K |
| 90710 |
|
94 |
72 |
$967.42 |
| 90715 |
|
90 |
78 |
$771.06 |
| 90700 |
|
42 |
37 |
$610.86 |
| 90716 |
|
16 |
12 |
$274.04 |
| 90707 |
|
15 |
12 |
$255.66 |
| 90685 |
|
15 |
15 |
$120.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
50 |
38 |
$0.00 |