| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,002 |
2,718 |
$141K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
533 |
488 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
532 |
488 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
392 |
340 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
344 |
331 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
256 |
212 |
$17K |
| 96127 |
|
712 |
664 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
327 |
303 |
$8K |
| 99173 |
|
669 |
609 |
$5K |
| D1206 |
Topical application of fluoride varnish |
164 |
119 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
211 |
83 |
$3K |
| 87428 |
|
44 |
44 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
172 |
155 |
$3K |
| 90686 |
|
175 |
167 |
$2K |
| 90734 |
|
92 |
91 |
$1K |
| 90648 |
|
91 |
82 |
$913.43 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
69 |
66 |
$730.98 |
| 90670 |
|
73 |
68 |
$646.71 |
| 83655 |
|
49 |
42 |
$533.70 |
| 90656 |
|
21 |
20 |
$360.48 |
| 90707 |
|
27 |
26 |
$317.14 |
| 90716 |
|
25 |
24 |
$283.72 |
| 90723 |
|
29 |
28 |
$256.15 |
| 90715 |
|
28 |
27 |
$179.20 |
| 85018 |
|
51 |
43 |
$109.04 |