| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
394 |
373 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
79 |
75 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
70 |
69 |
$4K |
| 92587 |
|
70 |
68 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
304 |
302 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
61 |
$4K |
| 3008F |
|
234 |
232 |
$3K |
| 83655 |
|
121 |
121 |
$2K |
| 92551 |
|
130 |
130 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
150 |
150 |
$2K |
| 99173 |
|
72 |
72 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$815.23 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
37 |
36 |
$600.79 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
16 |
$569.28 |
| 36416 |
|
163 |
161 |
$531.03 |
| 85018 |
|
139 |
139 |
$476.41 |
| 88738 |
|
56 |
55 |
$416.24 |
| 81002 |
|
111 |
107 |
$415.65 |
| 90686 |
|
53 |
53 |
$191.33 |
| 90670 |
|
12 |
12 |
$43.32 |