| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,390 |
2,020 |
$171K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,118 |
995 |
$120K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
783 |
739 |
$80K |
| D1206 |
Topical application of fluoride varnish |
3,126 |
3,110 |
$78K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
678 |
581 |
$63K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,897 |
2,655 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
586 |
570 |
$60K |
| 92552 |
|
1,116 |
1,076 |
$27K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
585 |
559 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
173 |
170 |
$20K |
| 90686 |
|
803 |
706 |
$17K |
| 90670 |
|
517 |
483 |
$11K |
| 90698 |
|
502 |
474 |
$11K |
| 90633 |
|
255 |
237 |
$5K |
| 90744 |
|
236 |
217 |
$5K |
| 90680 |
|
217 |
211 |
$5K |
| 90716 |
|
194 |
182 |
$4K |
| 90707 |
|
175 |
165 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
152 |
149 |
$3K |
| 99173 |
|
1,017 |
977 |
$3K |
| 83655 |
|
222 |
200 |
$2K |
| 96127 |
|
381 |
363 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
81 |
70 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
148 |
133 |
$2K |
| 3008F |
|
313 |
296 |
$1K |
| 90672 |
|
50 |
49 |
$1K |
| 94760 |
|
475 |
391 |
$1K |
| 99174 |
|
162 |
153 |
$979.20 |
| 90651 |
|
30 |
30 |
$698.40 |
| 85018 |
|
274 |
249 |
$554.39 |
| 0001A |
|
13 |
13 |
$520.00 |
| 90649 |
|
19 |
19 |
$442.32 |
| 96160 |
|
122 |
120 |
$332.15 |
| 90734 |
|
14 |
14 |
$325.92 |
| 90715 |
|
13 |
13 |
$302.64 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
14 |
13 |
$218.94 |
| 99051 |
|
41 |
39 |
$181.30 |
| 96161 |
|
63 |
60 |
$162.90 |
| 87807 |
|
14 |
13 |
$130.65 |
| 91300 |
|
33 |
30 |
$0.01 |
| 36416 |
|
322 |
256 |
$0.00 |
| INVCD |
|
29 |
27 |
$0.00 |