| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,982 |
1,650 |
$97K |
| D1206 |
Topical application of fluoride varnish |
648 |
565 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,192 |
1,320 |
$7K |
| 94760 |
|
4,295 |
3,480 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
845 |
750 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
63 |
57 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
71 |
61 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
249 |
209 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
194 |
176 |
$3K |
| 90686 |
|
239 |
217 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
690 |
626 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
196 |
96 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
51 |
45 |
$2K |
| 92551 |
|
116 |
111 |
$786.11 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
26 |
$680.32 |
| 90670 |
|
12 |
12 |
$232.80 |
| 99173 |
|
100 |
96 |
$183.12 |
| 86580 |
|
74 |
65 |
$135.23 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$107.65 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
25 |
$0.00 |