| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,736 |
2,438 |
$198K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
854 |
795 |
$91K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
719 |
718 |
$68K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
627 |
617 |
$52K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,988 |
1,958 |
$38K |
| 92587 |
|
609 |
609 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
192 |
192 |
$18K |
| 92567 |
|
1,257 |
1,225 |
$18K |
| 97802 |
|
734 |
734 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
590 |
332 |
$8K |
| 92552 |
|
243 |
242 |
$8K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
111 |
102 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
52 |
$5K |
| 90461 |
|
337 |
335 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
596 |
571 |
$4K |
| 99051 |
|
292 |
288 |
$3K |
| 83655 |
|
248 |
248 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
316 |
316 |
$2K |
| 99173 |
|
1,021 |
1,017 |
$2K |
| 99188 |
|
59 |
59 |
$1K |
| 99050 |
|
100 |
99 |
$676.65 |
| 90670 |
|
107 |
104 |
$615.36 |
| 85018 |
|
279 |
278 |
$523.10 |
| 96127 |
|
92 |
92 |
$506.24 |
| D1206 |
Topical application of fluoride varnish |
50 |
36 |
$404.16 |
| 88738 |
|
65 |
65 |
$49.06 |
| 81003 |
|
31 |
31 |
$43.56 |
| 90686 |
|
254 |
254 |
$40.64 |
| 36415 |
Collection of venous blood by venipuncture |
71 |
70 |
$29.25 |
| 90672 |
|
12 |
12 |
$27.54 |
| 99072 |
|
73 |
63 |
$20.00 |
| 96160 |
|
55 |
55 |
$2.76 |
| 90685 |
|
41 |
41 |
$0.00 |
| 3008F |
|
253 |
253 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 36416 |
|
128 |
128 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |