| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,932 |
4,544 |
$363K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,338 |
5,769 |
$296K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,389 |
2,045 |
$164K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,068 |
1,934 |
$158K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,312 |
1,253 |
$99K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
883 |
843 |
$73K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,240 |
1,130 |
$22K |
| 96127 |
|
944 |
845 |
$14K |
| D1206 |
Topical application of fluoride varnish |
389 |
339 |
$10K |
| 90686 |
|
1,078 |
997 |
$8K |
| 90670 |
|
826 |
791 |
$7K |
| 90651 |
|
315 |
290 |
$7K |
| 99215 |
Prolong outpt/office vis |
72 |
68 |
$4K |
| 90698 |
|
454 |
396 |
$4K |
| 83655 |
|
303 |
267 |
$4K |
| 90734 |
|
214 |
194 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
206 |
199 |
$3K |
| 90633 |
|
260 |
238 |
$2K |
| 90647 |
|
266 |
257 |
$2K |
| 90723 |
|
253 |
246 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
93 |
86 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
45 |
43 |
$990.67 |
| 85018 |
|
402 |
360 |
$919.60 |
| 90681 |
|
131 |
121 |
$836.48 |
| 90744 |
|
121 |
115 |
$784.64 |
| 90715 |
|
90 |
87 |
$678.35 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$333.45 |
| 90685 |
|
38 |
37 |
$290.72 |
| 36416 |
|
55 |
55 |
$225.50 |
| 90710 |
|
24 |
21 |
$153.60 |
| 90696 |
|
23 |
20 |
$147.20 |
| 90648 |
|
14 |
14 |
$106.63 |
| 90707 |
|
12 |
12 |
$78.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
40 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
36 |
28 |
$0.00 |