| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,101 |
2,749 |
$247K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,034 |
3,467 |
$200K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
858 |
821 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
533 |
416 |
$41K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
402 |
372 |
$34K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,501 |
1,347 |
$26K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,171 |
1,059 |
$18K |
| 99173 |
|
2,049 |
1,920 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
116 |
95 |
$8K |
| 83655 |
|
642 |
545 |
$8K |
| 85018 |
|
2,961 |
2,659 |
$7K |
| 96127 |
|
516 |
477 |
$7K |
| 90686 |
|
460 |
429 |
$5K |
| 96160 |
|
309 |
269 |
$5K |
| 87428 |
|
19 |
19 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
92 |
90 |
$3K |
| 90734 |
|
69 |
65 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
27 |
$953.91 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
656 |
563 |
$757.08 |
| 90716 |
|
51 |
41 |
$751.96 |
| D1206 |
Topical application of fluoride varnish |
28 |
15 |
$728.00 |
| 90619 |
|
43 |
41 |
$718.53 |
| 90648 |
|
40 |
40 |
$668.40 |
| 90707 |
|
52 |
42 |
$648.82 |
| 90670 |
|
44 |
38 |
$549.66 |
| 90651 |
|
28 |
25 |
$467.88 |
| 90715 |
|
33 |
33 |
$407.09 |
| 90723 |
|
14 |
14 |
$233.94 |
| 87400 |
|
14 |
14 |
$228.96 |
| 87807 |
|
17 |
17 |
$171.02 |
| 90696 |
|
17 |
12 |
$108.80 |
| 3008F |
|
12 |
12 |
$0.00 |