| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,839 |
1,723 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
743 |
740 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
742 |
701 |
$6K |
| D1206 |
Topical application of fluoride varnish |
160 |
160 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
237 |
236 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
235 |
234 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
128 |
125 |
$1K |
| 99173 |
|
286 |
286 |
$978.34 |
| 85018 |
|
401 |
401 |
$794.99 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
161 |
161 |
$781.38 |
| 92551 |
|
311 |
310 |
$738.34 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
378 |
378 |
$666.73 |
| 81003 |
|
255 |
255 |
$487.00 |
| 90670 |
|
228 |
228 |
$371.75 |
| 90656 |
|
69 |
69 |
$180.00 |
| 90686 |
|
31 |
30 |
$135.00 |
| 90685 |
|
73 |
72 |
$90.00 |
| 90680 |
|
135 |
135 |
$78.75 |
| 90688 |
|
27 |
27 |
$63.00 |
| 90633 |
|
135 |
135 |
$63.00 |
| 90744 |
|
61 |
61 |
$45.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
21 |
21 |
$37.65 |
| 90698 |
|
157 |
157 |
$31.50 |
| 90648 |
|
27 |
27 |
$27.00 |
| 90716 |
|
43 |
43 |
$18.00 |
| 90700 |
|
27 |
27 |
$18.00 |
| 90707 |
|
43 |
43 |
$18.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26 |
26 |
$9.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |
| 90710 |
|
24 |
24 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$0.00 |