| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
564 |
390 |
$54K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
515 |
389 |
$51K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
32 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14 |
14 |
$1K |
| D1206 |
Topical application of fluoride varnish |
15 |
15 |
$403.81 |
| 92567 |
|
362 |
308 |
$148.09 |
| 85018 |
|
801 |
589 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
487 |
359 |
$0.00 |
| 3074F |
|
39 |
32 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
65 |
47 |
$0.00 |
| 92551 |
|
24 |
13 |
$0.00 |
| 81001 |
|
38 |
27 |
$0.00 |
| 3008F |
|
85 |
65 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
28 |
$0.00 |
| 99173 |
|
705 |
510 |
$0.00 |
| 99401 |
|
203 |
147 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
65 |
47 |
$0.00 |
| 92550 |
|
136 |
101 |
$0.00 |
| 3078F |
|
48 |
38 |
$0.00 |
| 3725F |
|
64 |
46 |
$0.00 |
| 90734 |
|
31 |
28 |
$0.00 |
| 90715 |
|
14 |
13 |
$0.00 |