| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,192 |
5,359 |
$101K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,063 |
1,007 |
$56K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,677 |
2,502 |
$44K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
255 |
254 |
$26K |
| G9920 |
Screening performed and negative |
2,422 |
2,348 |
$25K |
| 0001A |
|
266 |
265 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
77 |
76 |
$10K |
| 0002A |
|
232 |
232 |
$9K |
| 0072A |
|
213 |
211 |
$8K |
| 0071A |
|
136 |
136 |
$5K |
| 90698 |
|
1,082 |
1,023 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
756 |
712 |
$5K |
| 90744 |
|
1,026 |
974 |
$5K |
| 90680 |
|
911 |
858 |
$5K |
| 90670 |
|
874 |
851 |
$4K |
| 97802 |
|
919 |
902 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
357 |
355 |
$3K |
| 0003A |
|
44 |
44 |
$2K |
| 92551 |
|
1,407 |
1,374 |
$2K |
| 90677 |
|
443 |
392 |
$1K |
| 99188 |
|
1,002 |
937 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
233 |
229 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
167 |
156 |
$568.26 |
| D1206 |
Topical application of fluoride varnish |
159 |
158 |
$320.76 |
| 90633 |
|
258 |
245 |
$252.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
124 |
119 |
$239.60 |
| 87428 |
|
307 |
283 |
$190.77 |
| 90707 |
|
186 |
177 |
$189.00 |
| 90716 |
|
200 |
191 |
$180.00 |
| 90658 |
|
132 |
129 |
$153.00 |
| 90656 |
|
208 |
199 |
$126.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$46.18 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
234 |
215 |
$41.38 |
| 90657 |
|
135 |
130 |
$36.00 |
| 90620 |
|
12 |
12 |
$36.00 |
| 90715 |
|
30 |
30 |
$36.00 |
| 90651 |
|
28 |
27 |
$27.00 |
| 90713 |
|
24 |
23 |
$27.00 |
| 90700 |
|
113 |
107 |
$27.00 |
| 85018 |
|
2,268 |
2,171 |
$0.00 |
| 99173 |
|
1,102 |
1,073 |
$0.00 |
| 81002 |
|
1,015 |
993 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
379 |
177 |
$0.00 |
| 97803 |
|
18 |
18 |
$0.00 |