| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,089 |
1,790 |
$123K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,691 |
2,298 |
$70K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,571 |
1,391 |
$67K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
816 |
783 |
$47K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
818 |
690 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
536 |
504 |
$29K |
| 92552 |
|
1,175 |
1,111 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
757 |
724 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
111 |
108 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
221 |
198 |
$2K |
| 99173 |
|
1,149 |
1,090 |
$2K |
| 90670 |
|
380 |
365 |
$2K |
| D1206 |
Topical application of fluoride varnish |
109 |
108 |
$1K |
| 90633 |
|
26 |
24 |
$740.33 |
| 90686 |
|
435 |
425 |
$533.54 |
| 96127 |
|
116 |
114 |
$457.41 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
16 |
$447.78 |
| 90658 |
|
373 |
338 |
$279.11 |
| 90672 |
|
130 |
128 |
$236.44 |
| 90698 |
|
128 |
121 |
$205.35 |
| 90685 |
|
120 |
118 |
$175.88 |
| 99050 |
|
13 |
12 |
$121.31 |
| 96161 |
|
24 |
24 |
$82.46 |
| 90680 |
|
64 |
62 |
$70.00 |
| 90744 |
|
27 |
26 |
$30.00 |
| 90707 |
|
15 |
15 |
$25.75 |
| 90700 |
|
27 |
24 |
$10.00 |