| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
803 |
688 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
178 |
172 |
$14K |
| D1206 |
Topical application of fluoride varnish |
685 |
673 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
153 |
145 |
$11K |
| D0190 |
|
683 |
672 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
96 |
95 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
438 |
425 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
52 |
43 |
$2K |
| 92551 |
|
177 |
173 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
86 |
49 |
$1K |
| 90670 |
|
88 |
88 |
$1K |
| 87210 |
|
204 |
180 |
$1K |
| 90648 |
|
88 |
86 |
$1K |
| 90686 |
|
46 |
46 |
$557.83 |
| 99174 |
|
86 |
82 |
$506.38 |
| 90723 |
|
42 |
42 |
$492.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
41 |
$489.76 |
| 89190 |
|
63 |
55 |
$327.75 |
| 99173 |
|
106 |
104 |
$261.47 |
| 3008F |
|
285 |
282 |
$208.00 |
| 96127 |
|
40 |
39 |
$202.99 |
| 83655 |
|
12 |
12 |
$176.04 |
| 3074F |
|
114 |
114 |
$163.80 |
| 3078F |
|
114 |
114 |
$160.60 |
| 90633 |
|
12 |
12 |
$160.13 |
| 90680 |
|
12 |
12 |
$138.05 |
| 90707 |
|
12 |
12 |
$136.40 |
| 90716 |
|
12 |
12 |
$136.40 |