| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,166 |
4,319 |
$277K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,042 |
909 |
$88K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,618 |
2,269 |
$82K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,023 |
773 |
$74K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
795 |
655 |
$71K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,495 |
2,706 |
$66K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
613 |
551 |
$54K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
711 |
614 |
$53K |
| 96127 |
|
1,705 |
1,516 |
$28K |
| 92552 |
|
2,135 |
1,907 |
$24K |
| 99173 |
|
2,148 |
1,914 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
902 |
719 |
$12K |
| 96161 |
|
819 |
635 |
$11K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,080 |
818 |
$11K |
| 36416 |
|
2,665 |
2,427 |
$8K |
| 82465 |
|
2,301 |
2,043 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
601 |
494 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
333 |
200 |
$4K |
| 81000 |
|
2,374 |
2,028 |
$4K |
| 99050 |
|
147 |
141 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
21 |
13 |
$844.04 |
| D0145 |
Oral evaluation for a patient under three years of age |
69 |
38 |
$575.00 |
| 83655 |
|
73 |
51 |
$531.76 |
| D1206 |
Topical application of fluoride varnish |
29 |
26 |
$460.00 |
| 85018 |
|
3,686 |
3,013 |
$108.48 |
| 90686 |
|
755 |
606 |
$38.45 |
| 90662 |
|
1,351 |
1,061 |
$0.03 |
| 90685 |
|
211 |
146 |
$0.01 |
| 90651 |
|
288 |
223 |
$0.00 |
| 90723 |
|
240 |
211 |
$0.00 |
| 90620 |
|
19 |
16 |
$0.00 |
| 90670 |
|
652 |
457 |
$0.00 |
| 90633 |
|
207 |
121 |
$0.00 |
| 90648 |
|
663 |
467 |
$0.00 |
| 90461 |
|
1,072 |
770 |
$0.00 |
| 90621 |
|
145 |
118 |
$0.00 |
| 90710 |
|
92 |
51 |
$0.00 |
| 90734 |
|
274 |
193 |
$0.00 |
| 90715 |
|
57 |
36 |
$0.00 |
| 90681 |
|
27 |
25 |
$0.00 |