| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,491 |
3,868 |
$251K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,440 |
1,297 |
$116K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
697 |
641 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
452 |
418 |
$30K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,626 |
1,492 |
$19K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
883 |
793 |
$17K |
| 87428 |
|
383 |
364 |
$9K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,374 |
1,282 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
200 |
188 |
$7K |
| 87631 |
|
61 |
59 |
$6K |
| 96160 |
|
1,660 |
1,562 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
321 |
306 |
$4K |
| 87807 |
|
200 |
181 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
53 |
49 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
149 |
62 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
136 |
122 |
$1K |
| 83655 |
|
150 |
134 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$880.42 |
| D1206 |
Topical application of fluoride varnish |
26 |
25 |
$664.74 |
| 96161 |
|
238 |
212 |
$356.20 |
| 99177 |
|
1,153 |
1,043 |
$285.00 |
| 92551 |
|
54 |
46 |
$284.85 |
| 96127 |
|
60 |
54 |
$157.61 |
| 99051 |
|
12 |
12 |
$135.05 |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
14 |
12 |
$73.71 |
| 85018 |
|
90 |
62 |
$66.72 |
| 90686 |
|
120 |
111 |
$0.13 |
| 90670 |
|
154 |
135 |
$0.01 |
| 36416 |
|
1,482 |
1,314 |
$0.00 |
| 90698 |
|
93 |
85 |
$0.00 |
| 90677 |
|
125 |
121 |
$0.00 |
| 90680 |
|
57 |
48 |
$0.00 |
| 99070 |
|
20 |
19 |
$0.00 |
| 99000 |
|
17 |
17 |
$0.00 |
| 90633 |
|
58 |
52 |
$0.00 |
| 99072 |
|
68 |
63 |
$0.00 |