| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
245 |
221 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
41 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
48 |
48 |
$3K |
| D1208 |
Topical application of fluoride, excluding varnish |
190 |
189 |
$2K |
| 83655 |
|
134 |
133 |
$2K |
| 92551 |
|
134 |
134 |
$2K |
| 3008F |
|
153 |
152 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
46 |
44 |
$734.82 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
17 |
$588.44 |
| 85018 |
|
147 |
146 |
$471.58 |
| 36416 |
|
151 |
150 |
$451.47 |
| 81002 |
|
134 |
126 |
$444.95 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
27 |
$233.01 |
| 88738 |
|
12 |
12 |
$81.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
13 |
$0.00 |