| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,762 |
6,133 |
$635K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,295 |
6,695 |
$477K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,894 |
5,771 |
$223K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,778 |
1,776 |
$163K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,339 |
1,334 |
$134K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,467 |
1,458 |
$134K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,359 |
1,264 |
$110K |
| 92552 |
|
2,688 |
2,675 |
$66K |
| 85013 |
|
4,734 |
4,732 |
$22K |
| 99441 |
|
579 |
555 |
$21K |
| 81000 |
|
4,709 |
4,626 |
$18K |
| 99215 |
Prolong outpt/office vis |
103 |
101 |
$13K |
| D1206 |
Topical application of fluoride varnish |
764 |
763 |
$11K |
| 99050 |
|
764 |
733 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
892 |
866 |
$10K |
| 99442 |
|
270 |
260 |
$9K |
| 87070 |
|
865 |
839 |
$8K |
| 99173 |
|
2,956 |
2,953 |
$7K |
| 83655 |
|
76 |
76 |
$1K |
| 99188 |
|
33 |
32 |
$940.78 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$211.27 |
| 90686 |
|
12 |
12 |
$145.93 |