| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,229 |
2,852 |
$198K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
792 |
771 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
926 |
899 |
$38K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
525 |
499 |
$36K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
393 |
390 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
308 |
291 |
$21K |
| 94010 |
|
385 |
365 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
240 |
234 |
$7K |
| 83655 |
|
495 |
478 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
305 |
301 |
$6K |
| 90686 |
|
1,009 |
947 |
$6K |
| 85018 |
|
1,881 |
1,821 |
$5K |
| 82465 |
|
974 |
942 |
$4K |
| 81003 |
|
1,378 |
1,335 |
$3K |
| 90723 |
|
99 |
97 |
$3K |
| 90670 |
|
234 |
226 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
15 |
15 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
71 |
66 |
$1K |
| 99188 |
|
73 |
64 |
$1K |
| D1206 |
Topical application of fluoride varnish |
38 |
38 |
$637.59 |
| 90647 |
|
109 |
103 |
$596.84 |
| 0072A |
|
13 |
13 |
$520.00 |
| 90651 |
|
49 |
42 |
$244.98 |
| 90734 |
|
31 |
31 |
$190.81 |
| 90685 |
|
15 |
15 |
$89.24 |
| 90633 |
|
13 |
13 |
$79.30 |
| 90681 |
|
12 |
12 |
$74.10 |
| 36416 |
|
14 |
13 |
$0.00 |
| 3008F |
|
12 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |
| 91307 |
|
23 |
21 |
$0.00 |
| G9920 |
Screening performed and negative |
15 |
14 |
$0.00 |