| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,750 |
6,387 |
$253K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,132 |
1,083 |
$60K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
953 |
932 |
$48K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
583 |
542 |
$33K |
| G9920 |
Screening performed and negative |
1,282 |
987 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
300 |
297 |
$17K |
| 92551 |
|
1,216 |
1,198 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
152 |
149 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
344 |
329 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
430 |
411 |
$7K |
| 90686 |
|
1,281 |
1,256 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
85 |
85 |
$6K |
| 99188 |
|
215 |
207 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
474 |
451 |
$2K |
| 90670 |
|
342 |
324 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 90672 |
|
78 |
78 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
63 |
51 |
$1K |
| 90651 |
|
32 |
32 |
$973.64 |
| 99173 |
|
753 |
744 |
$949.20 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$921.73 |
| 51798 |
|
69 |
63 |
$836.39 |
| 90723 |
|
128 |
118 |
$724.84 |
| 90647 |
|
150 |
137 |
$672.08 |
| D1206 |
Topical application of fluoride varnish |
30 |
30 |
$524.84 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
64 |
59 |
$513.30 |
| G9919 |
Screening performed and positive and provision of recommendations |
20 |
17 |
$435.00 |
| 90680 |
|
68 |
68 |
$398.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
41 |
39 |
$289.15 |
| 90710 |
|
28 |
27 |
$126.01 |
| 90633 |
|
15 |
15 |
$120.04 |
| 90696 |
|
25 |
24 |
$108.01 |
| 90685 |
|
12 |
12 |
$81.14 |
| 85018 |
|
44 |
39 |
$76.59 |
| 96127 |
|
15 |
13 |
$72.15 |
| 90715 |
|
18 |
18 |
$72.00 |
| 99177 |
|
37 |
37 |
$51.22 |
| 90734 |
|
12 |
12 |
$45.00 |
| 81002 |
|
12 |
12 |
$27.89 |
| 90461 |
|
39 |
39 |
$0.00 |