| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,103 |
5,523 |
$259K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,177 |
1,163 |
$89K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,216 |
2,143 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
738 |
725 |
$54K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
687 |
655 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
593 |
572 |
$38K |
| 90461 |
|
809 |
796 |
$24K |
| 92551 |
|
1,848 |
1,815 |
$19K |
| 99173 |
|
1,720 |
1,692 |
$12K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,266 |
1,218 |
$11K |
| D1206 |
Topical application of fluoride varnish |
736 |
722 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
107 |
105 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
522 |
511 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
462 |
225 |
$6K |
| 96127 |
|
1,394 |
1,369 |
$5K |
| 90633 |
|
314 |
302 |
$4K |
| 90688 |
|
786 |
770 |
$4K |
| 90670 |
|
412 |
399 |
$3K |
| 90648 |
|
395 |
382 |
$3K |
| 90687 |
|
280 |
276 |
$2K |
| 90723 |
|
144 |
139 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
45 |
45 |
$1K |
| 96160 |
|
449 |
418 |
$1K |
| 90680 |
|
130 |
125 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$753.91 |
| 90707 |
|
52 |
51 |
$727.73 |
| 90651 |
|
39 |
39 |
$630.20 |
| 90716 |
|
52 |
51 |
$588.80 |
| 90700 |
|
40 |
39 |
$189.54 |
| 96161 |
|
102 |
100 |
$179.14 |
| 81002 |
|
15 |
15 |
$48.72 |
| 36416 |
|
31 |
30 |
$5.49 |
| 3008F |
|
2,180 |
2,162 |
$0.00 |
| 2014F |
|
568 |
564 |
$0.00 |
| 99072 |
|
89 |
83 |
$0.00 |