| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,284 |
3,584 |
$201K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,370 |
1,238 |
$113K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,455 |
1,269 |
$109K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,413 |
1,259 |
$104K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
593 |
571 |
$82K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,097 |
882 |
$73K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
764 |
747 |
$69K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,923 |
3,510 |
$63K |
| 92558 |
|
2,473 |
2,156 |
$30K |
| 99174 |
|
921 |
681 |
$17K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
219 |
212 |
$12K |
| 90686 |
|
999 |
858 |
$9K |
| 90700 |
|
870 |
743 |
$8K |
| 83655 |
|
551 |
472 |
$7K |
| 90670 |
|
623 |
542 |
$5K |
| 92567 |
|
349 |
299 |
$5K |
| 92015 |
Determination of refractive state |
270 |
257 |
$5K |
| 90713 |
|
539 |
461 |
$5K |
| 90651 |
|
565 |
447 |
$5K |
| 90620 |
|
455 |
371 |
$5K |
| 90734 |
|
438 |
349 |
$4K |
| 90648 |
|
388 |
335 |
$4K |
| D1206 |
Topical application of fluoride varnish |
132 |
108 |
$3K |
| 92587 |
|
220 |
216 |
$3K |
| 90716 |
|
224 |
195 |
$2K |
| 90707 |
|
219 |
190 |
$2K |
| 36416 |
|
513 |
443 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
113 |
93 |
$2K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
15 |
15 |
$2K |
| 90744 |
|
170 |
155 |
$1K |
| 85018 |
|
616 |
532 |
$1K |
| 90633 |
|
173 |
154 |
$1K |
| 90680 |
|
145 |
104 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
59 |
33 |
$1K |
| 90698 |
|
193 |
124 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$1K |
| 99053 |
|
81 |
81 |
$841.59 |
| 90715 |
|
85 |
82 |
$629.80 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
27 |
25 |
$391.50 |
| 81002 |
|
116 |
95 |
$293.80 |
| 90672 |
|
40 |
30 |
$249.60 |
| 90685 |
|
17 |
16 |
$108.80 |
| 99177 |
|
572 |
497 |
$0.00 |