| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,894 |
2,104 |
$230K |
| 87428 |
|
873 |
743 |
$31K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,127 |
931 |
$14K |
| D1206 |
Topical application of fluoride varnish |
433 |
405 |
$10K |
| 87807 |
|
833 |
713 |
$9K |
| 90686 |
|
326 |
264 |
$6K |
| 92551 |
|
613 |
554 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
49 |
45 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
48 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
43 |
36 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
437 |
377 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
113 |
54 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
16 |
12 |
$667.29 |
| W7010 |
|
46 |
43 |
$650.94 |
| 99173 |
|
255 |
237 |
$628.30 |
| 96127 |
|
110 |
96 |
$490.61 |
| 90648 |
|
13 |
12 |
$303.16 |
| 96160 |
|
122 |
93 |
$287.44 |
| 90651 |
|
12 |
12 |
$260.72 |
| 90656 |
|
14 |
13 |
$232.80 |
| 99072 |
|
15 |
15 |
$0.00 |