| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,841 |
3,703 |
$388K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
908 |
818 |
$108K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,023 |
1,646 |
$92K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
880 |
798 |
$87K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
852 |
769 |
$85K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
745 |
663 |
$79K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
664 |
603 |
$62K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,632 |
1,504 |
$15K |
| 90686 |
|
698 |
647 |
$14K |
| 90670 |
|
457 |
430 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
665 |
326 |
$8K |
| 90648 |
|
388 |
352 |
$8K |
| 92551 |
|
820 |
787 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
447 |
395 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
52 |
48 |
$5K |
| 92552 |
|
185 |
185 |
$5K |
| 96127 |
|
855 |
815 |
$5K |
| D1206 |
Topical application of fluoride varnish |
178 |
174 |
$4K |
| 99383 |
|
34 |
34 |
$4K |
| 90723 |
|
171 |
164 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
42 |
30 |
$4K |
| 99382 |
|
31 |
31 |
$3K |
| 90685 |
|
125 |
115 |
$3K |
| 99384 |
|
17 |
17 |
$2K |
| 99173 |
|
830 |
807 |
$2K |
| 90700 |
|
82 |
77 |
$2K |
| 90707 |
|
76 |
68 |
$2K |
| 99381 |
|
13 |
13 |
$2K |
| 90680 |
|
62 |
61 |
$1K |
| 90716 |
|
61 |
57 |
$1K |
| 90633 |
|
67 |
58 |
$1K |
| 90651 |
|
58 |
56 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
19 |
17 |
$1K |
| 90734 |
|
62 |
51 |
$1K |
| 87807 |
|
88 |
77 |
$918.06 |
| 94760 |
|
371 |
324 |
$912.60 |
| 96161 |
|
289 |
257 |
$687.11 |
| 90621 |
|
15 |
13 |
$464.30 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
57 |
56 |
$456.00 |
| 96160 |
|
174 |
173 |
$426.58 |
| 2015F |
|
13 |
13 |
$200.00 |