| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,381 |
2,013 |
$111K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
779 |
644 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
255 |
222 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
725 |
617 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
169 |
163 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
185 |
175 |
$6K |
| 99173 |
|
685 |
636 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
45 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
241 |
233 |
$4K |
| D1206 |
Topical application of fluoride varnish |
121 |
96 |
$3K |
| 96127 |
|
187 |
163 |
$3K |
| 83655 |
|
205 |
177 |
$2K |
| 85018 |
|
1,031 |
943 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
34 |
25 |
$2K |
| 90686 |
|
220 |
182 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
451 |
419 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
25 |
$621.25 |
| 90670 |
|
19 |
16 |
$581.88 |
| 90461 |
|
64 |
60 |
$529.75 |
| 90648 |
|
32 |
28 |
$204.80 |
| 99051 |
|
13 |
13 |
$0.00 |