| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,397 |
7,162 |
$946K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,069 |
3,702 |
$324K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,850 |
1,756 |
$193K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,412 |
1,335 |
$160K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,431 |
1,372 |
$151K |
| D1206 |
Topical application of fluoride varnish |
4,662 |
2,930 |
$116K |
| 99460 |
|
1,326 |
1,208 |
$113K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,774 |
1,234 |
$113K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
980 |
868 |
$94K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,341 |
1,225 |
$87K |
| 90658 |
|
2,844 |
2,651 |
$61K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
6,402 |
5,962 |
$52K |
| 90651 |
|
981 |
877 |
$21K |
| 90670 |
|
800 |
760 |
$18K |
| 90648 |
|
791 |
754 |
$17K |
| 90734 |
|
550 |
533 |
$12K |
| 0002A |
|
265 |
251 |
$10K |
| 0001A |
|
232 |
223 |
$8K |
| 90657 |
|
362 |
346 |
$8K |
| 90680 |
|
314 |
298 |
$7K |
| 0003A |
|
184 |
157 |
$6K |
| 90723 |
|
242 |
231 |
$5K |
| 90715 |
|
243 |
222 |
$5K |
| 90716 |
|
166 |
163 |
$4K |
| 90649 |
|
152 |
148 |
$4K |
| 90707 |
|
136 |
134 |
$3K |
| 90633 |
|
67 |
65 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
99 |
94 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
76 |
70 |
$687.85 |
| 90620 |
|
30 |
29 |
$686.76 |
| 90700 |
|
29 |
29 |
$675.12 |
| 99173 |
|
111 |
110 |
$281.84 |
| 99188 |
|
25 |
25 |
$52.36 |
| 91300 |
|
323 |
270 |
$0.06 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
35 |
33 |
$0.00 |