| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,964 |
4,895 |
$482K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,412 |
2,034 |
$265K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
194 |
187 |
$21K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
488 |
440 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
156 |
132 |
$16K |
| 96127 |
|
2,531 |
2,116 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
112 |
107 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
119 |
100 |
$12K |
| D1206 |
Topical application of fluoride varnish |
399 |
396 |
$10K |
| 90686 |
|
438 |
421 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
589 |
560 |
$6K |
| 92552 |
|
178 |
174 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
361 |
270 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
304 |
129 |
$3K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
72 |
70 |
$3K |
| 96160 |
|
719 |
658 |
$2K |
| 90656 |
|
50 |
46 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
35 |
34 |
$823.90 |
| 99174 |
|
61 |
60 |
$382.84 |
| 90670 |
|
12 |
12 |
$279.36 |
| 99051 |
|
14 |
12 |
$275.00 |
| 99173 |
|
71 |
71 |
$179.98 |
| 94760 |
|
39 |
32 |
$7.91 |
| 99072 |
|
534 |
457 |
$0.00 |
| 99401 |
|
60 |
56 |
$0.00 |
| 99188 |
|
82 |
79 |
$0.00 |
| 90661 |
|
26 |
26 |
$0.00 |
| 36416 |
|
40 |
38 |
$0.00 |
| INVCD |
|
28 |
26 |
$0.00 |