| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,006 |
906 |
$64K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
523 |
477 |
$47K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
960 |
896 |
$39K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
325 |
307 |
$32K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
273 |
234 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
461 |
423 |
$17K |
| 92567 |
|
725 |
626 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
562 |
499 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
560 |
532 |
$4K |
| 92587 |
|
207 |
188 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
359 |
145 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$3K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
87 |
85 |
$2K |
| 99383 |
|
18 |
17 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$2K |
| 87807 |
|
128 |
99 |
$1K |
| 99050 |
|
71 |
69 |
$932.40 |
| D1206 |
Topical application of fluoride varnish |
22 |
14 |
$671.58 |
| 94010 |
|
29 |
22 |
$639.66 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
14 |
$335.39 |
| 99058 |
|
18 |
14 |
$264.75 |
| 93000 |
|
17 |
16 |
$204.32 |
| 99188 |
|
16 |
15 |
$184.50 |
| 94760 |
|
130 |
124 |
$139.20 |
| 90648 |
|
235 |
221 |
$0.00 |
| 90713 |
|
218 |
209 |
$0.00 |
| 90707 |
|
13 |
12 |
$0.00 |
| 90700 |
|
307 |
285 |
$0.00 |
| 90670 |
|
244 |
232 |
$0.00 |
| 90633 |
|
55 |
55 |
$0.00 |
| 90685 |
|
19 |
19 |
$0.00 |
| 99000 |
|
341 |
309 |
$0.00 |
| 90686 |
|
31 |
31 |
$0.00 |
| 90680 |
|
67 |
67 |
$0.00 |
| 90716 |
|
13 |
12 |
$0.00 |
| 90744 |
|
86 |
77 |
$0.00 |