| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,680 |
1,542 |
$128K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,167 |
1,078 |
$59K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
835 |
760 |
$59K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
834 |
740 |
$57K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,218 |
1,113 |
$51K |
| D0145 |
Oral evaluation for a patient under three years of age |
693 |
610 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,685 |
1,474 |
$15K |
| D1206 |
Topical application of fluoride varnish |
698 |
613 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
454 |
409 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
274 |
262 |
$7K |
| 99381 |
|
97 |
95 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
220 |
212 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
55 |
$4K |
| 83655 |
|
273 |
235 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
216 |
203 |
$3K |
| 90474 |
|
77 |
76 |
$2K |
| 96127 |
|
208 |
186 |
$794.75 |
| 69210 |
|
15 |
15 |
$538.80 |
| 85018 |
|
326 |
286 |
$446.76 |
| 99051 |
|
12 |
12 |
$317.76 |
| 90686 |
|
264 |
236 |
$162.23 |
| 96161 |
|
73 |
38 |
$138.38 |
| 90633 |
|
333 |
291 |
$32.14 |
| 92551 |
|
366 |
338 |
$23.00 |
| 99173 |
|
468 |
430 |
$12.00 |
| 94760 |
|
15 |
14 |
$2.07 |
| 90670 |
|
682 |
661 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |
| 90707 |
|
14 |
14 |
$0.00 |
| 90744 |
|
419 |
341 |
$0.00 |
| 36416 |
|
103 |
80 |
$0.00 |
| 90680 |
|
418 |
416 |
$0.00 |
| 90698 |
|
682 |
662 |
$0.00 |
| 90716 |
|
15 |
15 |
$0.00 |