| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,220 |
2,843 |
$156K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
792 |
732 |
$58K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
614 |
507 |
$46K |
| 96160 |
|
1,814 |
1,600 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
487 |
430 |
$36K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
409 |
375 |
$33K |
| 96127 |
|
1,067 |
927 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,328 |
1,110 |
$24K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
144 |
114 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
291 |
260 |
$7K |
| 90686 |
|
724 |
639 |
$6K |
| 0071A |
|
96 |
95 |
$4K |
| 0072A |
|
93 |
93 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
242 |
224 |
$3K |
| 90674 |
|
146 |
135 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
58 |
55 |
$2K |
| 90672 |
|
163 |
155 |
$2K |
| 90648 |
|
64 |
50 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
38 |
$939.00 |
| 90734 |
|
60 |
38 |
$816.76 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
16 |
16 |
$662.08 |
| 90651 |
|
36 |
25 |
$564.21 |
| 90670 |
|
45 |
37 |
$556.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
31 |
$471.00 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$340.60 |
| 83655 |
|
15 |
12 |
$177.90 |
| 85018 |
|
53 |
38 |
$122.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
292 |
227 |
$0.00 |