| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,188 |
9,308 |
$768K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,989 |
5,207 |
$611K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,207 |
8,107 |
$298K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,907 |
2,583 |
$279K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,657 |
2,211 |
$260K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,715 |
2,241 |
$246K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,126 |
1,828 |
$194K |
| 99401 |
|
2,685 |
2,145 |
$75K |
| 96127 |
|
3,776 |
3,244 |
$57K |
| 92552 |
|
5,208 |
4,536 |
$57K |
| 99174 |
|
2,367 |
2,044 |
$40K |
| 96160 |
|
1,862 |
1,533 |
$27K |
| 99173 |
|
3,861 |
3,327 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,206 |
871 |
$15K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,413 |
1,164 |
$10K |
| D1206 |
Topical application of fluoride varnish |
425 |
405 |
$6K |
| 99188 |
|
368 |
268 |
$5K |
| 92551 |
|
706 |
703 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
225 |
209 |
$2K |
| 0071A |
|
54 |
44 |
$2K |
| 0072A |
|
30 |
29 |
$1K |
| 69210 |
|
29 |
25 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
25 |
23 |
$263.35 |
| 81002 |
|
5,507 |
4,811 |
$134.60 |
| 90461 |
|
280 |
187 |
$14.68 |
| 90710 |
|
266 |
242 |
$0.01 |
| 91307 |
|
110 |
85 |
$0.01 |
| 90633 |
|
489 |
430 |
$0.00 |
| 90648 |
|
342 |
310 |
$0.00 |
| 90671 |
|
281 |
260 |
$0.00 |
| 90670 |
|
1,000 |
925 |
$0.00 |
| 90734 |
|
502 |
419 |
$0.00 |
| 90681 |
|
50 |
49 |
$0.00 |
| 90715 |
|
82 |
81 |
$0.00 |
| 90649 |
|
123 |
122 |
$0.00 |
| 90620 |
|
273 |
227 |
$0.00 |
| 90680 |
|
412 |
398 |
$0.00 |
| 90697 |
|
97 |
96 |
$0.00 |
| 90686 |
|
3,832 |
3,446 |
$0.00 |
| 90677 |
|
115 |
111 |
$0.00 |
| 90651 |
|
744 |
637 |
$0.00 |
| 90619 |
|
222 |
214 |
$0.00 |
| 90723 |
|
28 |
26 |
$0.00 |
| 90656 |
|
507 |
491 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90698 |
|
54 |
54 |
$0.00 |
| 91305 |
|
28 |
14 |
$0.00 |