| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,201 |
1,098 |
$73K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,599 |
1,547 |
$73K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,137 |
1,117 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
854 |
810 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
351 |
342 |
$23K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
305 |
297 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
249 |
247 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
157 |
153 |
$10K |
| 99051 |
|
231 |
225 |
$8K |
| 96127 |
|
1,146 |
1,060 |
$4K |
| 96160 |
|
266 |
255 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
41 |
41 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
50 |
50 |
$2K |
| D1206 |
Topical application of fluoride varnish |
91 |
84 |
$2K |
| 0001A |
|
31 |
30 |
$1K |
| 96161 |
|
186 |
177 |
$1K |
| 0071A |
|
29 |
29 |
$874.00 |
| 0002A |
|
16 |
16 |
$630.00 |
| 90686 |
|
948 |
940 |
$100.48 |
| 90713 |
|
243 |
239 |
$0.00 |
| 99072 |
|
2,187 |
1,893 |
$0.00 |
| 90670 |
|
184 |
183 |
$0.00 |
| 90461 |
|
538 |
531 |
$0.00 |
| 90700 |
|
328 |
326 |
$0.00 |
| 90707 |
|
16 |
16 |
$0.00 |
| 91300 |
|
84 |
73 |
$0.00 |
| 90685 |
|
51 |
51 |
$0.00 |
| 90633 |
|
46 |
45 |
$0.00 |
| 90744 |
|
44 |
44 |
$0.00 |
| 90680 |
|
109 |
109 |
$0.00 |
| 90647 |
|
258 |
254 |
$0.00 |
| 91307 |
|
31 |
29 |
$0.00 |
| 99000 |
|
27 |
26 |
$0.00 |