| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12,071 |
10,152 |
$708K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,423 |
6,238 |
$226K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,121 |
2,771 |
$158K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,094 |
2,496 |
$145K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,280 |
1,058 |
$51K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
865 |
776 |
$44K |
| 96112 |
|
544 |
436 |
$24K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,508 |
1,394 |
$17K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
713 |
319 |
$8K |
| 96111 |
|
105 |
101 |
$6K |
| 90633 |
|
746 |
645 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
65 |
59 |
$4K |
| 99051 |
|
160 |
144 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
979 |
824 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
154 |
140 |
$2K |
| 92551 |
|
159 |
145 |
$867.16 |
| 90698 |
|
1,522 |
1,283 |
$810.00 |
| 99173 |
|
203 |
187 |
$411.96 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
19 |
$258.91 |
| 90680 |
|
1,104 |
926 |
$160.00 |
| 90696 |
|
42 |
42 |
$160.00 |
| 90670 |
|
1,998 |
1,679 |
$25.00 |
| 90686 |
|
1,212 |
1,087 |
$19.03 |
| 90685 |
|
859 |
737 |
$0.00 |
| 90707 |
|
32 |
26 |
$0.00 |
| 90710 |
|
41 |
41 |
$0.00 |
| 90744 |
|
636 |
526 |
$0.00 |
| 90716 |
|
47 |
27 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |