| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,367 |
5,045 |
$290K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
782 |
610 |
$59K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
737 |
638 |
$56K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
589 |
536 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
578 |
467 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
503 |
436 |
$36K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,199 |
1,075 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,150 |
925 |
$19K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,021 |
495 |
$19K |
| 90670 |
|
466 |
383 |
$9K |
| 90651 |
|
229 |
197 |
$8K |
| 92558 |
|
414 |
342 |
$5K |
| 90686 |
|
458 |
405 |
$4K |
| 90633 |
|
312 |
277 |
$3K |
| 90734 |
|
182 |
167 |
$3K |
| 90647 |
|
283 |
222 |
$2K |
| 90700 |
|
246 |
212 |
$2K |
| D1206 |
Topical application of fluoride varnish |
56 |
43 |
$1K |
| 83655 |
|
107 |
80 |
$1K |
| 90723 |
|
157 |
114 |
$1K |
| 90680 |
|
110 |
74 |
$946.27 |
| 90715 |
|
71 |
64 |
$841.42 |
| 90716 |
|
26 |
25 |
$589.15 |
| 90713 |
|
64 |
60 |
$505.51 |
| 36416 |
|
125 |
107 |
$496.10 |
| 90707 |
|
16 |
15 |
$327.52 |
| 85018 |
|
143 |
122 |
$327.41 |
| 81002 |
|
123 |
114 |
$319.80 |
| 90710 |
|
47 |
40 |
$300.80 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
19 |
13 |
$275.50 |
| 94664 |
|
19 |
13 |
$258.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,212 |
1,085 |
$33.36 |
| 90461 |
|
551 |
486 |
$32.58 |
| 97803 |
|
395 |
305 |
$15.00 |