| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,773 |
3,328 |
$183K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,133 |
1,022 |
$83K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,051 |
851 |
$79K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
733 |
624 |
$57K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
593 |
554 |
$46K |
| 87428 |
|
292 |
262 |
$18K |
| 96127 |
|
1,200 |
1,035 |
$17K |
| 90651 |
|
284 |
238 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
522 |
450 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
268 |
250 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
313 |
233 |
$6K |
| D1206 |
Topical application of fluoride varnish |
211 |
144 |
$6K |
| 90686 |
|
439 |
395 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
289 |
120 |
$4K |
| 83655 |
|
284 |
219 |
$3K |
| 90734 |
|
224 |
183 |
$3K |
| 99173 |
|
279 |
254 |
$2K |
| 90715 |
|
113 |
93 |
$1K |
| 90648 |
|
68 |
40 |
$1K |
| 85018 |
|
353 |
280 |
$814.63 |
| 90633 |
|
61 |
50 |
$773.83 |
| 90716 |
|
77 |
67 |
$721.37 |
| 90707 |
|
75 |
66 |
$718.88 |
| 90620 |
|
16 |
16 |
$267.36 |
| 90696 |
|
19 |
14 |
$121.60 |