| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,871 |
1,708 |
$129K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
983 |
901 |
$76K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
737 |
691 |
$50K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
442 |
375 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
182 |
155 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
430 |
338 |
$12K |
| 90686 |
|
1,187 |
1,079 |
$8K |
| 90670 |
|
632 |
596 |
$5K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
70 |
65 |
$5K |
| 90698 |
|
538 |
504 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
269 |
261 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
80 |
78 |
$4K |
| 90651 |
|
54 |
43 |
$2K |
| 90633 |
|
259 |
241 |
$2K |
| 90680 |
|
231 |
220 |
$2K |
| D1206 |
Topical application of fluoride varnish |
31 |
27 |
$806.00 |
| 90744 |
|
124 |
119 |
$761.60 |
| 90734 |
|
46 |
44 |
$701.19 |
| 96127 |
|
37 |
36 |
$481.80 |
| 90685 |
|
43 |
42 |
$292.67 |
| 90710 |
|
34 |
31 |
$211.20 |
| 90696 |
|
25 |
25 |
$160.00 |
| 90715 |
|
12 |
12 |
$87.87 |
| 90716 |
|
12 |
12 |
$76.80 |
| 36415 |
Collection of venous blood by venipuncture |
95 |
95 |
$72.68 |
| 99188 |
|
47 |
44 |
$0.00 |