| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,141 |
970 |
$68K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
860 |
755 |
$65K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
716 |
589 |
$58K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
474 |
410 |
$34K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
986 |
857 |
$22K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,368 |
1,156 |
$15K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
676 |
567 |
$4K |
| D0145 |
Oral evaluation for a patient under three years of age |
91 |
89 |
$3K |
| 96160 |
|
1,253 |
1,100 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
183 |
161 |
$2K |
| 83655 |
|
121 |
101 |
$990.42 |
| 87428 |
|
14 |
14 |
$925.96 |
| 96161 |
|
531 |
447 |
$814.37 |
| 90670 |
|
577 |
517 |
$690.87 |
| 92551 |
|
88 |
63 |
$536.80 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
12 |
12 |
$488.52 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$289.30 |
| 87807 |
|
12 |
12 |
$129.69 |
| 96127 |
|
26 |
25 |
$88.10 |
| 99173 |
|
32 |
16 |
$48.30 |
| 90686 |
|
126 |
106 |
$21.94 |
| 85018 |
|
16 |
16 |
$17.04 |
| 99177 |
|
799 |
713 |
$4.00 |
| 99072 |
|
25 |
25 |
$0.00 |
| 90698 |
|
338 |
291 |
$0.00 |
| 90680 |
|
345 |
294 |
$0.00 |
| 90677 |
|
57 |
39 |
$0.00 |
| 36416 |
|
740 |
625 |
$0.00 |
| 90744 |
|
126 |
105 |
$0.00 |