| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,046 |
5,251 |
$434K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,738 |
1,328 |
$131K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,471 |
1,097 |
$100K |
| 92552 |
|
3,640 |
2,754 |
$67K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
779 |
533 |
$66K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,641 |
1,088 |
$41K |
| 92082 |
|
1,068 |
812 |
$34K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,794 |
1,372 |
$11K |
| 90686 |
|
444 |
358 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,178 |
902 |
$8K |
| W7010 |
|
745 |
473 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
253 |
157 |
$8K |
| 99177 |
|
1,763 |
1,374 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
138 |
128 |
$5K |
| 90688 |
|
468 |
318 |
$5K |
| 96127 |
|
1,389 |
928 |
$4K |
| 0071A |
|
96 |
89 |
$3K |
| 0072A |
|
76 |
69 |
$3K |
| 99175 |
|
566 |
360 |
$3K |
| 90651 |
|
238 |
158 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
83 |
75 |
$2K |
| 90734 |
|
193 |
116 |
$2K |
| 90670 |
|
279 |
165 |
$2K |
| 90698 |
|
267 |
162 |
$2K |
| 90658 |
|
96 |
86 |
$2K |
| 90633 |
|
205 |
128 |
$1K |
| D1206 |
Topical application of fluoride varnish |
61 |
41 |
$1K |
| 90656 |
|
67 |
48 |
$1K |
| 90744 |
|
229 |
141 |
$1K |
| 90716 |
|
166 |
104 |
$1K |
| 90707 |
|
165 |
104 |
$1K |
| 90674 |
|
51 |
41 |
$819.96 |
| 99174 |
|
98 |
91 |
$563.15 |
| 90671 |
|
28 |
24 |
$519.04 |
| 90680 |
|
90 |
56 |
$465.60 |
| 90620 |
|
24 |
13 |
$465.60 |
| 90715 |
|
65 |
42 |
$419.04 |
| 90380 |
|
16 |
15 |
$309.51 |
| 99408 |
|
35 |
33 |
$274.40 |
| 90710 |
|
15 |
12 |
$232.80 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
13 |
$218.70 |
| 90713 |
|
46 |
32 |
$139.68 |
| 90685 |
|
58 |
25 |
$139.68 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34 |
17 |
$125.02 |
| 99172 |
|
55 |
28 |
$117.00 |
| 90700 |
|
46 |
32 |
$116.40 |
| 96161 |
|
134 |
84 |
$95.05 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
42 |
25 |
$90.00 |
| 91307 |
|
174 |
146 |
$0.00 |
| 99443 |
|
16 |
13 |
$0.00 |
| 99442 |
|
83 |
65 |
$0.00 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
26 |
17 |
$0.00 |
| 91300 |
|
16 |
14 |
$0.00 |