| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,009 |
2,743 |
$151K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
872 |
809 |
$66K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,511 |
1,411 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
891 |
819 |
$17K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
342 |
328 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
111 |
108 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
112 |
92 |
$7K |
| 87081 |
|
999 |
931 |
$7K |
| 99051 |
|
233 |
215 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
376 |
184 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
42 |
42 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
43 |
39 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
639 |
582 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
285 |
267 |
$3K |
| D0145 |
Oral evaluation for a patient under three years of age |
25 |
24 |
$829.20 |
| 81005 |
|
306 |
256 |
$498.99 |
| D1206 |
Topical application of fluoride varnish |
25 |
24 |
$366.00 |
| 99173 |
|
465 |
436 |
$23.00 |
| 92551 |
|
173 |
157 |
$3.00 |
| 90670 |
|
15 |
15 |
$0.00 |
| 36416 |
|
412 |
375 |
$0.00 |
| 90698 |
|
13 |
12 |
$0.00 |