| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,395 |
3,758 |
$202K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,042 |
1,724 |
$147K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,019 |
981 |
$78K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
925 |
892 |
$78K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
929 |
851 |
$72K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
598 |
571 |
$41K |
| 92551 |
|
2,447 |
2,317 |
$38K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,760 |
1,640 |
$33K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
925 |
848 |
$25K |
| 90651 |
|
548 |
520 |
$18K |
| 99173 |
|
1,745 |
1,655 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,133 |
977 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
591 |
557 |
$12K |
| 90670 |
|
679 |
635 |
$11K |
| 90686 |
|
1,310 |
1,167 |
$10K |
| D1206 |
Topical application of fluoride varnish |
298 |
295 |
$8K |
| 90710 |
|
276 |
252 |
$7K |
| 90734 |
|
402 |
376 |
$6K |
| 81002 |
|
2,285 |
2,114 |
$6K |
| 90620 |
|
260 |
240 |
$6K |
| 90715 |
|
482 |
455 |
$5K |
| 90723 |
|
465 |
439 |
$4K |
| 90647 |
|
498 |
473 |
$4K |
| 90633 |
|
310 |
280 |
$3K |
| 85018 |
|
1,027 |
968 |
$2K |
| 90685 |
|
273 |
243 |
$2K |
| 90688 |
|
76 |
58 |
$2K |
| 90681 |
|
149 |
138 |
$2K |
| 90672 |
|
203 |
196 |
$1K |
| 99381 |
|
12 |
12 |
$1K |
| 90696 |
|
73 |
68 |
$920.42 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
26 |
$666.90 |
| 36415 |
Collection of venous blood by venipuncture |
61 |
56 |
$250.10 |
| 86580 |
|
14 |
12 |
$56.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
35 |
35 |
$0.00 |