| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,802 |
4,536 |
$349K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,021 |
1,926 |
$211K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,038 |
1,019 |
$99K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
847 |
835 |
$80K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
605 |
575 |
$54K |
| 99499 |
|
1,038 |
1,021 |
$27K |
| 99429 |
|
969 |
950 |
$24K |
| 99188 |
|
1,853 |
1,737 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
187 |
183 |
$19K |
| D1206 |
Topical application of fluoride varnish |
420 |
400 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
301 |
271 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
322 |
297 |
$6K |
| D9999 |
Unspecified adjunctive procedure, by report |
203 |
182 |
$4K |
| 90633 |
|
417 |
409 |
$4K |
| 90670 |
|
200 |
196 |
$3K |
| 90686 |
|
193 |
191 |
$3K |
| 90688 |
|
196 |
193 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
49 |
49 |
$2K |
| 90672 |
|
125 |
124 |
$2K |
| 90461 |
|
203 |
191 |
$2K |
| 99173 |
|
996 |
980 |
$2K |
| 92081 |
|
105 |
105 |
$1K |
| 90680 |
|
70 |
70 |
$1K |
| 90697 |
|
86 |
83 |
$1K |
| 96127 |
|
276 |
268 |
$842.02 |
| 90685 |
|
30 |
28 |
$589.31 |
| 90658 |
|
21 |
20 |
$374.84 |
| 90473 |
|
19 |
19 |
$323.76 |
| 90651 |
|
41 |
40 |
$307.94 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$286.13 |
| 90744 |
|
13 |
12 |
$162.70 |
| 99174 |
|
43 |
43 |
$129.96 |
| 90648 |
|
13 |
12 |
$116.02 |
| 99177 |
|
45 |
44 |
$96.42 |
| 96161 |
|
51 |
50 |
$84.39 |
| U0001 |
Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
152 |
146 |
$0.00 |