| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,057 |
13,542 |
$762K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,728 |
6,575 |
$580K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,640 |
2,059 |
$198K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,890 |
1,732 |
$139K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,495 |
1,290 |
$101K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,216 |
1,126 |
$96K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,566 |
2,409 |
$63K |
| D1206 |
Topical application of fluoride varnish |
1,808 |
1,380 |
$47K |
| 96127 |
|
2,895 |
2,612 |
$41K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,554 |
1,072 |
$28K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,210 |
482 |
$21K |
| 87428 |
|
299 |
296 |
$19K |
| 90670 |
|
1,241 |
1,035 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,131 |
977 |
$16K |
| 90686 |
|
1,474 |
1,313 |
$16K |
| 90734 |
|
567 |
481 |
$15K |
| 99173 |
|
1,575 |
1,416 |
$11K |
| 90648 |
|
1,205 |
1,034 |
$11K |
| 90716 |
|
571 |
472 |
$10K |
| 83655 |
|
918 |
728 |
$9K |
| 90651 |
|
222 |
197 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
639 |
591 |
$8K |
| 90707 |
|
551 |
441 |
$7K |
| 90633 |
|
727 |
589 |
$7K |
| 90723 |
|
705 |
615 |
$7K |
| 99233 |
Prolong inpt eval add15 m |
644 |
147 |
$6K |
| 90715 |
|
216 |
171 |
$3K |
| 85018 |
|
1,054 |
828 |
$2K |
| 90685 |
|
185 |
153 |
$2K |
| 90696 |
|
109 |
90 |
$2K |
| 99223 |
Prolong inpt eval add15 m |
61 |
52 |
$1K |
| 99383 |
|
13 |
13 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
94 |
79 |
$1K |
| 90681 |
|
113 |
105 |
$945.30 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
53 |
24 |
$768.50 |
| 90700 |
|
58 |
51 |
$514.84 |
| 90677 |
|
18 |
13 |
$300.78 |
| 86580 |
|
69 |
58 |
$276.00 |
| 69210 |
|
13 |
12 |
$267.50 |
| 90461 |
|
35 |
21 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
59 |
37 |
$0.00 |