| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,161 |
1,037 |
$73K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,334 |
1,166 |
$58K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,029 |
846 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
843 |
694 |
$45K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
409 |
324 |
$21K |
| 90648 |
|
836 |
664 |
$13K |
| D1206 |
Topical application of fluoride varnish |
305 |
247 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
472 |
405 |
$8K |
| 90686 |
|
559 |
417 |
$8K |
| 90723 |
|
510 |
410 |
$8K |
| 90670 |
|
523 |
438 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
124 |
104 |
$6K |
| 90633 |
|
344 |
283 |
$5K |
| 96127 |
|
331 |
271 |
$5K |
| 87428 |
|
71 |
66 |
$5K |
| 90677 |
|
139 |
124 |
$3K |
| 83655 |
|
255 |
210 |
$3K |
| 99383 |
|
29 |
26 |
$2K |
| 90656 |
|
113 |
111 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
47 |
44 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
80 |
$1K |
| 85018 |
|
492 |
367 |
$1K |
| 99382 |
|
22 |
14 |
$1K |
| 90651 |
|
61 |
47 |
$840.23 |
| 90681 |
|
55 |
51 |
$821.48 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
16 |
15 |
$609.12 |
| 90734 |
|
47 |
32 |
$485.35 |
| 90715 |
|
40 |
27 |
$428.52 |
| 80061 |
Lipid panel |
51 |
36 |
$423.23 |
| 87807 |
|
37 |
31 |
$337.12 |
| 90619 |
|
17 |
17 |
$300.79 |
| 90710 |
|
16 |
14 |
$277.24 |
| 90696 |
|
15 |
14 |
$258.86 |
| 82947 |
|
51 |
36 |
$188.61 |