| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,439 |
5,727 |
$325K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,736 |
2,177 |
$210K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,634 |
2,238 |
$180K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,125 |
980 |
$85K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
725 |
647 |
$60K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
692 |
625 |
$59K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,282 |
1,971 |
$58K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,136 |
1,818 |
$34K |
| D1206 |
Topical application of fluoride varnish |
1,214 |
950 |
$32K |
| 90686 |
|
2,752 |
2,415 |
$30K |
| 90648 |
|
1,955 |
1,636 |
$23K |
| 90670 |
|
1,631 |
1,333 |
$18K |
| 90723 |
|
1,346 |
1,125 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,171 |
1,082 |
$14K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
91 |
88 |
$13K |
| 92587 |
|
830 |
687 |
$11K |
| 90633 |
|
736 |
597 |
$10K |
| 90677 |
|
425 |
378 |
$8K |
| 90681 |
|
627 |
543 |
$8K |
| 69210 |
|
253 |
213 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
1,217 |
990 |
$5K |
| 96127 |
|
229 |
208 |
$5K |
| 90734 |
|
270 |
221 |
$5K |
| 90651 |
|
224 |
178 |
$4K |
| 96160 |
|
299 |
260 |
$4K |
| 96112 |
|
62 |
54 |
$2K |
| 90710 |
|
108 |
92 |
$2K |
| 99000 |
|
58 |
40 |
$1K |
| 90716 |
|
82 |
71 |
$1K |
| 90620 |
|
78 |
63 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
76 |
75 |
$1K |
| 90661 |
|
71 |
69 |
$1K |
| 90707 |
|
76 |
57 |
$1K |
| 90696 |
|
64 |
49 |
$978.14 |
| 90656 |
|
57 |
52 |
$952.47 |
| 91318 |
|
50 |
43 |
$835.50 |
| 90715 |
|
46 |
45 |
$771.95 |
| 90700 |
|
59 |
45 |
$758.81 |
| 96111 |
|
50 |
27 |
$636.74 |
| 85018 |
|
224 |
198 |
$517.36 |
| 90660 |
|
12 |
12 |
$193.27 |
| 99173 |
|
12 |
12 |
$89.40 |
| 81003 |
|
30 |
24 |
$65.40 |
| 82465 |
|
14 |
14 |
$59.36 |
| 1036F |
|
548 |
478 |
$0.00 |
| 96161 |
|
86 |
83 |
$0.00 |
| 1003F |
|
1,579 |
1,358 |
$0.00 |
| 3725F |
|
384 |
346 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
16 |
$0.00 |