| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,309 |
5,283 |
$750K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,551 |
775 |
$85K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
533 |
447 |
$52K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
544 |
447 |
$49K |
| 92081 |
|
1,558 |
1,308 |
$44K |
| 92551 |
|
2,320 |
1,912 |
$19K |
| 90686 |
|
1,016 |
794 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
211 |
138 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,015 |
1,352 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
152 |
107 |
$11K |
| W7010 |
|
656 |
572 |
$9K |
| 96127 |
|
2,133 |
1,800 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
675 |
205 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
51 |
46 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
160 |
99 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
337 |
195 |
$3K |
| 90651 |
|
137 |
112 |
$2K |
| D1206 |
Topical application of fluoride varnish |
46 |
46 |
$1K |
| W7000 |
|
187 |
162 |
$771.00 |
| 96160 |
|
390 |
271 |
$731.28 |
| 0071A |
|
27 |
19 |
$720.00 |
| 99173 |
|
391 |
271 |
$657.80 |
| 0001A |
|
15 |
15 |
$600.00 |
| 0002A |
|
15 |
12 |
$400.00 |
| 90672 |
|
19 |
12 |
$356.40 |
| 90734 |
|
15 |
12 |
$256.08 |
| 99401 |
|
24 |
18 |
$90.00 |
| 96161 |
|
19 |
13 |
$36.01 |
| 91307 |
|
33 |
19 |
$0.00 |
| INVCD |
|
12 |
12 |
$0.00 |
| 91300 |
|
109 |
83 |
$0.00 |