| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,070 |
11,279 |
$714K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,939 |
2,836 |
$255K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,967 |
1,949 |
$172K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,473 |
1,466 |
$130K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
917 |
916 |
$86K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,033 |
1,019 |
$84K |
| 92552 |
|
3,547 |
3,517 |
$71K |
| 90688 |
|
1,528 |
1,518 |
$19K |
| D0120 |
Periodic oral evaluation - established patient |
502 |
496 |
$14K |
| 83655 |
|
946 |
933 |
$13K |
| 80061 |
Lipid panel |
856 |
849 |
$12K |
| 90698 |
|
890 |
879 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
720 |
713 |
$10K |
| 36416 |
|
3,911 |
3,863 |
$10K |
| 85018 |
|
3,638 |
3,604 |
$9K |
| 90670 |
|
807 |
799 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
100 |
100 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
228 |
226 |
$8K |
| 99173 |
|
3,810 |
3,781 |
$6K |
| 96127 |
|
975 |
963 |
$5K |
| 90685 |
|
406 |
405 |
$5K |
| 82947 |
|
932 |
923 |
$4K |
| D1206 |
Topical application of fluoride varnish |
214 |
212 |
$4K |
| 90710 |
|
338 |
335 |
$3K |
| 90651 |
|
291 |
289 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
99 |
96 |
$3K |
| 90633 |
|
245 |
241 |
$2K |
| 90734 |
|
186 |
184 |
$2K |
| 90672 |
|
102 |
102 |
$2K |
| 90680 |
|
164 |
162 |
$2K |
| 99383 |
|
12 |
12 |
$1K |
| 99460 |
|
14 |
14 |
$1K |
| 96161 |
|
348 |
341 |
$810.11 |
| 90620 |
|
48 |
48 |
$680.41 |
| 90686 |
|
44 |
44 |
$665.72 |
| 90744 |
|
86 |
81 |
$663.24 |
| 90715 |
|
64 |
61 |
$467.80 |
| 94664 |
|
41 |
41 |
$421.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
31 |
30 |
$382.67 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
38 |
38 |
$381.82 |
| 90696 |
|
38 |
36 |
$245.68 |
| 81002 |
|
26 |
24 |
$80.08 |
| 94760 |
|
15 |
14 |
$0.00 |