| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,642 |
11,575 |
$523K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15,311 |
6,635 |
$226K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,776 |
2,652 |
$177K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,585 |
2,505 |
$149K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,879 |
1,791 |
$96K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,168 |
1,140 |
$65K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
352 |
350 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
538 |
513 |
$14K |
| 90633 |
|
514 |
500 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
956 |
483 |
$11K |
| D1208 |
Topical application of fluoride, excluding varnish |
697 |
680 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
675 |
654 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
409 |
402 |
$3K |
| 90670 |
|
1,441 |
1,373 |
$2K |
| 92552 |
|
86 |
84 |
$1K |
| 99381 |
|
14 |
14 |
$864.49 |
| 90698 |
|
816 |
775 |
$821.10 |
| 81002 |
|
320 |
315 |
$800.70 |
| 90686 |
|
1,815 |
1,781 |
$781.46 |
| 85018 |
|
301 |
294 |
$596.46 |
| 99173 |
|
290 |
279 |
$571.80 |
| 96127 |
|
141 |
140 |
$500.20 |
| 90680 |
|
439 |
417 |
$442.00 |
| 36416 |
|
248 |
243 |
$441.42 |
| 90744 |
|
259 |
249 |
$341.50 |
| 99177 |
|
29 |
29 |
$317.26 |
| 90685 |
|
325 |
313 |
$315.75 |
| 90461 |
|
1,075 |
865 |
$157.50 |
| 90651 |
|
150 |
148 |
$15.75 |
| 90710 |
|
41 |
37 |
$15.75 |
| 90734 |
|
75 |
73 |
$10.00 |
| 99000 |
|
714 |
696 |
$0.00 |
| 90696 |
|
16 |
12 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90715 |
|
37 |
37 |
$0.00 |