| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,249 |
4,393 |
$275K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,177 |
1,160 |
$92K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
935 |
920 |
$72K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
731 |
686 |
$45K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
389 |
388 |
$31K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,678 |
2,575 |
$20K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,353 |
1,299 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
466 |
449 |
$4K |
| D0190 |
|
304 |
303 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
236 |
212 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$2K |
| D1206 |
Topical application of fluoride varnish |
224 |
203 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
78 |
67 |
$1K |
| 96127 |
|
385 |
382 |
$1K |
| 83655 |
|
100 |
79 |
$983.90 |
| 0001A |
|
22 |
22 |
$840.25 |
| 0002A |
|
12 |
12 |
$457.22 |
| 90474 |
|
102 |
82 |
$369.84 |
| 85018 |
|
84 |
79 |
$175.13 |
| 90651 |
|
65 |
64 |
$172.08 |
| 90734 |
|
38 |
38 |
$128.85 |
| 90686 |
|
735 |
728 |
$119.59 |
| 36415 |
Collection of venous blood by venipuncture |
69 |
66 |
$44.50 |
| 81003 |
|
15 |
14 |
$24.52 |
| 90656 |
|
93 |
93 |
$19.77 |
| 90670 |
|
540 |
517 |
$0.00 |
| 91300 |
|
67 |
53 |
$0.00 |
| 90633 |
|
151 |
147 |
$0.00 |
| 90648 |
|
94 |
75 |
$0.00 |
| 90685 |
|
101 |
98 |
$0.00 |
| 90680 |
|
100 |
81 |
$0.00 |
| 90698 |
|
192 |
192 |
$0.00 |
| 90723 |
|
32 |
14 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |
| 90744 |
|
25 |
25 |
$0.00 |