| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,904 |
1,462 |
$223K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,665 |
1,953 |
$218K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,158 |
1,240 |
$91K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
715 |
422 |
$70K |
| 99215 |
Prolong outpt/office vis |
874 |
239 |
$53K |
| 99051 |
|
4,138 |
1,419 |
$51K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
526 |
298 |
$48K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
419 |
268 |
$37K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
262 |
158 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,883 |
1,718 |
$23K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,412 |
1,040 |
$20K |
| 92552 |
|
1,808 |
1,044 |
$18K |
| 99205 |
Prolong outpt/office vis |
128 |
45 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,096 |
321 |
$9K |
| 99070 |
|
2,409 |
935 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
233 |
182 |
$8K |
| 96127 |
|
1,431 |
761 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
132 |
62 |
$5K |
| D0145 |
Oral evaluation for a patient under three years of age |
94 |
55 |
$4K |
| D1206 |
Topical application of fluoride varnish |
94 |
55 |
$2K |
| 87807 |
|
87 |
23 |
$568.72 |
| 90670 |
|
398 |
263 |
$0.00 |
| 90710 |
|
103 |
40 |
$0.00 |
| 99173 |
|
1,858 |
1,072 |
$0.00 |
| 90461 |
|
610 |
281 |
$0.00 |
| 90685 |
|
24 |
12 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
17 |
15 |
$0.00 |
| 90633 |
|
24 |
12 |
$0.00 |
| 90686 |
|
463 |
257 |
$0.00 |
| 90647 |
|
137 |
93 |
$0.00 |
| 90680 |
|
90 |
64 |
$0.00 |
| 86769 |
|
79 |
32 |
$0.00 |
| 90723 |
|
94 |
67 |
$0.00 |
| 90656 |
|
54 |
54 |
$0.00 |
| 90697 |
|
24 |
12 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |