| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,111 |
1,676 |
$186K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,685 |
1,430 |
$97K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
650 |
515 |
$50K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
352 |
350 |
$32K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
348 |
347 |
$31K |
| D0120 |
Periodic oral evaluation - established patient |
389 |
354 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
87 |
87 |
$9K |
| D1208 |
Topical application of fluoride, excluding varnish |
522 |
481 |
$9K |
| D9999 |
Unspecified adjunctive procedure, by report |
330 |
300 |
$8K |
| 99443 |
|
257 |
233 |
$6K |
| 90670 |
|
269 |
262 |
$3K |
| 81002 |
|
667 |
645 |
$2K |
| 90648 |
|
121 |
119 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
16 |
16 |
$1K |
| 90686 |
|
108 |
108 |
$1K |
| 90685 |
|
89 |
84 |
$1K |
| 90680 |
|
85 |
84 |
$1K |
| 92567 |
|
127 |
99 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
49 |
49 |
$897.39 |
| 90688 |
|
76 |
75 |
$717.58 |
| 99460 |
|
22 |
14 |
$655.52 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
20 |
12 |
$461.66 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
13 |
$346.41 |
| 90723 |
|
12 |
12 |
$202.53 |
| 90716 |
|
15 |
15 |
$92.70 |
| 90687 |
|
13 |
13 |
$83.92 |
| 90707 |
|
13 |
13 |
$80.78 |
| 90651 |
|
13 |
13 |
$80.48 |
| 90633 |
|
13 |
13 |
$80.18 |
| 94760 |
|
200 |
160 |
$49.51 |