| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,269 |
1,124 |
$95K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
837 |
763 |
$42K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
522 |
487 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
131 |
123 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
129 |
117 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
200 |
184 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
105 |
98 |
$8K |
| 92567 |
|
383 |
360 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
334 |
318 |
$4K |
| D0145 |
Oral evaluation for a patient under three years of age |
56 |
50 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
46 |
45 |
$1K |
| 99354 |
|
15 |
14 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
110 |
107 |
$908.43 |
| D1206 |
Topical application of fluoride varnish |
56 |
50 |
$778.00 |
| 36415 |
Collection of venous blood by venipuncture |
274 |
253 |
$691.20 |
| 81002 |
|
75 |
65 |
$204.75 |
| 90734 |
|
20 |
17 |
$119.01 |
| 92551 |
|
456 |
431 |
$56.02 |
| 99173 |
|
460 |
434 |
$26.00 |
| 90649 |
|
45 |
44 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| 90685 |
|
20 |
16 |
$0.00 |
| 90670 |
|
16 |
13 |
$0.00 |
| 90686 |
|
156 |
146 |
$0.00 |