| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,499 |
5,744 |
$297K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,566 |
3,218 |
$259K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,838 |
1,547 |
$149K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,837 |
1,627 |
$136K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,107 |
866 |
$83K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,070 |
1,679 |
$36K |
| 96127 |
|
1,656 |
1,453 |
$23K |
| 90686 |
|
1,565 |
1,434 |
$14K |
| 83655 |
|
1,189 |
915 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
485 |
480 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
169 |
150 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
406 |
391 |
$11K |
| 90651 |
|
593 |
512 |
$6K |
| 85018 |
|
2,692 |
2,185 |
$6K |
| 90734 |
|
375 |
322 |
$4K |
| 99173 |
|
468 |
420 |
$3K |
| 92015 |
Determination of refractive state |
180 |
164 |
$3K |
| 90670 |
|
267 |
224 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
755 |
711 |
$3K |
| 36416 |
|
574 |
501 |
$2K |
| 90621 |
|
120 |
92 |
$1K |
| 92587 |
|
53 |
50 |
$1K |
| 94060 |
|
16 |
15 |
$843.20 |
| 90685 |
|
86 |
82 |
$550.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
25 |
24 |
$392.50 |
| D1206 |
Topical application of fluoride varnish |
16 |
13 |
$390.00 |
| 86580 |
|
84 |
71 |
$342.98 |
| 90715 |
|
50 |
41 |
$340.30 |
| 90697 |
|
19 |
15 |
$317.49 |
| 90674 |
|
19 |
15 |
$317.49 |
| 90633 |
|
38 |
29 |
$275.23 |
| 69210 |
|
13 |
13 |
$257.87 |
| 90723 |
|
15 |
15 |
$170.80 |
| 90647 |
|
19 |
19 |
$147.83 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
57 |
37 |
$90.90 |
| 90680 |
|
14 |
13 |
$89.60 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
102 |
99 |
$0.76 |
| 1036F |
|
276 |
191 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
324 |
296 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
157 |
133 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
17 |
14 |
$0.00 |
| 90461 |
|
14 |
12 |
$0.00 |