| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,807 |
5,006 |
$281K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,573 |
2,257 |
$201K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,621 |
1,745 |
$200K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,516 |
1,105 |
$104K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,221 |
873 |
$92K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,649 |
2,157 |
$66K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,460 |
1,353 |
$60K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,005 |
1,562 |
$55K |
| D1206 |
Topical application of fluoride varnish |
1,963 |
1,332 |
$51K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,111 |
1,006 |
$50K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
471 |
375 |
$39K |
| 96127 |
|
2,149 |
1,608 |
$31K |
| 90670 |
|
1,185 |
840 |
$22K |
| 99000 |
|
1,928 |
1,443 |
$17K |
| 92587 |
|
1,208 |
765 |
$17K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
395 |
374 |
$14K |
| 90651 |
|
252 |
158 |
$12K |
| 90686 |
|
1,075 |
812 |
$9K |
| 85018 |
|
3,913 |
2,561 |
$9K |
| 87807 |
|
892 |
764 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
331 |
277 |
$8K |
| 87428 |
|
151 |
138 |
$8K |
| 90700 |
|
529 |
301 |
$6K |
| 90698 |
|
626 |
436 |
$6K |
| 86580 |
|
1,204 |
738 |
$6K |
| 90633 |
|
514 |
308 |
$5K |
| 90734 |
|
91 |
49 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
274 |
244 |
$4K |
| 81002 |
|
1,318 |
891 |
$3K |
| 90680 |
|
352 |
258 |
$3K |
| 90677 |
|
27 |
25 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
911 |
510 |
$3K |
| 90685 |
|
232 |
133 |
$2K |
| 36416 |
|
459 |
332 |
$2K |
| 90713 |
|
134 |
81 |
$2K |
| 90744 |
|
226 |
162 |
$2K |
| 83655 |
|
91 |
73 |
$1K |
| 90710 |
|
64 |
30 |
$1K |
| 0072A |
|
25 |
25 |
$1K |
| 90715 |
|
42 |
27 |
$935.10 |
| 90619 |
|
48 |
48 |
$802.08 |
| 90648 |
|
19 |
12 |
$251.84 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
43 |
29 |
$246.82 |
| 90656 |
|
12 |
12 |
$200.52 |
| 96161 |
|
368 |
279 |
$15.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16 |
16 |
$4.51 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,003 |
2,044 |
$0.00 |
| 90461 |
|
1,653 |
1,022 |
$0.00 |
| 99072 |
|
14 |
12 |
$0.00 |