| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,876 |
4,114 |
$509K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,269 |
3,414 |
$317K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
804 |
742 |
$77K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
746 |
699 |
$72K |
| D1206 |
Topical application of fluoride varnish |
2,289 |
2,259 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
586 |
516 |
$51K |
| 92552 |
|
1,405 |
1,310 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
164 |
150 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,570 |
1,268 |
$14K |
| 90686 |
|
284 |
265 |
$6K |
| 90670 |
|
229 |
208 |
$4K |
| 90698 |
|
224 |
210 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
471 |
367 |
$4K |
| 96127 |
|
948 |
864 |
$4K |
| 99173 |
|
1,389 |
1,295 |
$3K |
| 87400 |
|
279 |
216 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
149 |
128 |
$2K |
| 96161 |
|
415 |
356 |
$766.09 |
| 90710 |
|
12 |
12 |
$232.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
33 |
31 |
$39.48 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
23 |
$0.00 |
| 90461 |
|
26 |
13 |
$0.00 |