| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42,729 |
36,069 |
$174K |
| 99381 |
|
453 |
436 |
$48K |
| 0001A |
|
805 |
805 |
$31K |
| 0002A |
|
777 |
771 |
$28K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,289 |
2,875 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,749 |
3,649 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,494 |
4,371 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,920 |
5,748 |
$5K |
| 0003A |
|
119 |
119 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,437 |
5,277 |
$3K |
| 92552 |
|
2,617 |
2,584 |
$3K |
| 90670 |
|
3,844 |
3,446 |
$3K |
| 92551 |
|
9,984 |
9,700 |
$2K |
| 0011A |
|
55 |
55 |
$2K |
| 90658 |
|
7,787 |
7,634 |
$2K |
| 0012A |
|
51 |
51 |
$2K |
| 90698 |
|
2,720 |
2,425 |
$2K |
| 85018 |
|
18,600 |
17,840 |
$2K |
| 90733 |
|
640 |
339 |
$1K |
| 0124A |
|
32 |
32 |
$1K |
| G9920 |
Screening performed and negative |
3,235 |
3,200 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,941 |
1,796 |
$993.18 |
| 90744 |
|
2,017 |
1,771 |
$938.70 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
698 |
599 |
$777.32 |
| 0073A |
|
19 |
19 |
$730.00 |
| 90680 |
|
2,033 |
1,738 |
$697.50 |
| 0072A |
|
16 |
16 |
$640.00 |
| 99173 |
|
10,089 |
9,782 |
$560.68 |
| D1206 |
Topical application of fluoride varnish |
6,663 |
6,504 |
$498.96 |
| 81000 |
|
10,836 |
10,482 |
$493.23 |
| 81002 |
|
2,189 |
2,161 |
$363.64 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
751 |
696 |
$275.52 |
| 90700 |
|
1,401 |
1,335 |
$260.10 |
| 90707 |
|
2,032 |
1,953 |
$252.00 |
| 90657 |
|
1,597 |
1,486 |
$248.40 |
| 90716 |
|
2,036 |
1,956 |
$243.00 |
| 90633 |
|
2,054 |
1,932 |
$207.90 |
| 90620 |
|
1,578 |
1,449 |
$205.20 |
| 90649 |
|
3,777 |
3,453 |
$184.50 |
| 83655 |
|
619 |
602 |
$138.84 |
| 90715 |
|
1,083 |
909 |
$106.20 |
| 90713 |
|
531 |
489 |
$98.10 |
| 90648 |
|
703 |
647 |
$95.40 |
| 90734 |
|
1,461 |
1,453 |
$36.00 |
| 86580 |
|
925 |
888 |
$9.99 |
| 90696 |
|
234 |
232 |
$9.00 |
| 96127 |
|
478 |
477 |
$4.81 |
| 92081 |
|
2,060 |
2,047 |
$0.00 |
| 99188 |
|
1,655 |
1,614 |
$0.00 |
| 91300 |
|
102 |
98 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
80 |
77 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$0.00 |
| 90660 |
|
1,662 |
1,623 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
20 |
20 |
$0.00 |