| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,451 |
12,862 |
$1.31M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,364 |
2,147 |
$262K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,962 |
1,874 |
$200K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,713 |
1,670 |
$180K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,821 |
1,632 |
$162K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,255 |
1,229 |
$144K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,507 |
4,291 |
$42K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,520 |
2,287 |
$29K |
| 90698 |
|
1,342 |
1,256 |
$28K |
| 92552 |
|
1,038 |
995 |
$24K |
| 90670 |
|
1,076 |
1,018 |
$23K |
| 90688 |
|
904 |
864 |
$21K |
| 96127 |
|
1,842 |
1,783 |
$16K |
| 90680 |
|
703 |
655 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
870 |
825 |
$14K |
| 90633 |
|
505 |
483 |
$11K |
| 90710 |
|
454 |
437 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,081 |
573 |
$10K |
| 90744 |
|
445 |
433 |
$10K |
| 90734 |
|
363 |
354 |
$8K |
| D1206 |
Topical application of fluoride varnish |
264 |
258 |
$6K |
| 0072A |
|
143 |
143 |
$6K |
| 0071A |
|
138 |
138 |
$6K |
| 99173 |
|
2,247 |
2,164 |
$6K |
| 90686 |
|
260 |
231 |
$5K |
| 90677 |
|
233 |
217 |
$5K |
| 90620 |
|
200 |
192 |
$4K |
| 99381 |
|
52 |
46 |
$3K |
| 90651 |
|
159 |
154 |
$3K |
| 96161 |
|
911 |
851 |
$2K |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
42 |
35 |
$2K |
| 90696 |
|
72 |
71 |
$2K |
| 87807 |
|
189 |
150 |
$2K |
| 90715 |
|
61 |
59 |
$1K |
| 90685 |
|
51 |
44 |
$1K |
| 0074A |
|
12 |
12 |
$480.00 |
| 90656 |
|
97 |
97 |
$325.92 |
| 94760 |
|
140 |
102 |
$140.66 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
15 |
14 |
$130.00 |
| H0003 |
Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs |
19 |
14 |
$63.40 |
| 84030 |
|
28 |
24 |
$36.34 |
| 91307 |
|
162 |
150 |
$0.08 |
| 99000 |
|
17 |
17 |
$0.00 |
| 36416 |
|
17 |
12 |
$0.00 |