| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,357 |
1,981 |
$109K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,090 |
825 |
$84K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
925 |
760 |
$68K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
608 |
548 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
222 |
210 |
$17K |
| 90686 |
|
826 |
742 |
$7K |
| D1206 |
Topical application of fluoride varnish |
153 |
114 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
191 |
77 |
$3K |
| 90648 |
|
458 |
384 |
$3K |
| 90670 |
|
403 |
343 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
117 |
114 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
27 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
50 |
48 |
$1K |
| 83655 |
|
93 |
69 |
$1K |
| 99215 |
Prolong outpt/office vis |
15 |
12 |
$999.11 |
| 90656 |
|
50 |
50 |
$926.47 |
| 90723 |
|
141 |
128 |
$898.60 |
| 87428 |
|
14 |
14 |
$890.26 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
57 |
44 |
$856.09 |
| 90680 |
|
107 |
97 |
$753.75 |
| 85018 |
|
318 |
262 |
$731.65 |
| 90715 |
|
38 |
38 |
$634.98 |
| 90734 |
|
38 |
38 |
$634.98 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
18 |
17 |
$532.10 |
| 90633 |
|
46 |
36 |
$302.12 |