| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,369 |
2,851 |
$313K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
986 |
929 |
$130K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,053 |
929 |
$104K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
755 |
731 |
$83K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
198 |
192 |
$22K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
482 |
467 |
$19K |
| 90648 |
|
687 |
662 |
$15K |
| D1206 |
Topical application of fluoride varnish |
535 |
531 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,083 |
1,043 |
$12K |
| 90670 |
|
473 |
452 |
$10K |
| 90723 |
|
458 |
439 |
$10K |
| 90686 |
|
413 |
403 |
$9K |
| 90680 |
|
396 |
380 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
208 |
203 |
$5K |
| 90633 |
|
215 |
208 |
$5K |
| 90671 |
|
188 |
186 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
329 |
318 |
$4K |
| 99177 |
|
646 |
627 |
$3K |
| 92551 |
|
324 |
311 |
$3K |
| 96127 |
|
656 |
638 |
$3K |
| 92587 |
|
116 |
113 |
$3K |
| 90656 |
|
118 |
118 |
$3K |
| 90685 |
|
135 |
120 |
$2K |
| 90661 |
|
71 |
71 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$2K |
| 96161 |
|
613 |
566 |
$2K |
| 99460 |
|
16 |
13 |
$1K |
| 83655 |
|
83 |
81 |
$907.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$742.08 |
| 99173 |
|
172 |
169 |
$441.48 |
| 85018 |
|
209 |
202 |
$386.94 |
| 96160 |
|
159 |
120 |
$366.75 |
| 87807 |
|
30 |
28 |
$289.09 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
12 |
$279.84 |
| 36416 |
|
23 |
14 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
74 |
69 |
$0.00 |