| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,365 |
2,068 |
$139K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
315 |
289 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
281 |
257 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
178 |
168 |
$13K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
408 |
359 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
578 |
382 |
$12K |
| 99173 |
|
576 |
533 |
$10K |
| 92551 |
|
645 |
596 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
577 |
516 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
99 |
83 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
101 |
88 |
$6K |
| 90686 |
|
402 |
376 |
$5K |
| 3008F |
|
834 |
764 |
$5K |
| 87807 |
|
290 |
241 |
$3K |
| 96127 |
|
566 |
522 |
$3K |
| 99188 |
|
226 |
198 |
$2K |
| 99000 |
|
369 |
334 |
$1K |
| D1208 |
Topical application of fluoride, excluding varnish |
95 |
95 |
$1K |
| 83655 |
|
90 |
76 |
$992.85 |
| 90651 |
|
79 |
67 |
$983.70 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
12 |
$807.31 |
| 90619 |
|
49 |
49 |
$735.60 |
| 90716 |
|
53 |
49 |
$708.31 |
| 90707 |
|
51 |
47 |
$696.66 |
| 90633 |
|
30 |
30 |
$450.00 |
| 90677 |
|
28 |
28 |
$430.80 |
| 36416 |
|
182 |
154 |
$375.09 |
| 90674 |
|
28 |
26 |
$371.70 |
| 90715 |
|
28 |
26 |
$360.00 |
| 90696 |
|
26 |
25 |
$351.66 |
| 90620 |
|
14 |
14 |
$203.10 |
| 90647 |
|
12 |
12 |
$180.00 |
| 80061 |
Lipid panel |
19 |
16 |
$152.89 |
| 85018 |
|
32 |
32 |
$97.09 |
| 81002 |
|
28 |
26 |
$83.64 |
| 88738 |
|
12 |
12 |
$81.96 |
| 82947 |
|
19 |
16 |
$48.84 |
| 82948 |
|
18 |
15 |
$31.99 |
| 90461 |
|
273 |
255 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
649 |
598 |
$0.00 |