| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,792 |
1,550 |
$134K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,711 |
1,510 |
$89K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
367 |
354 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,290 |
1,227 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
271 |
257 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
159 |
156 |
$12K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
634 |
607 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
106 |
96 |
$9K |
| D0145 |
Oral evaluation for a patient under three years of age |
303 |
295 |
$9K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
263 |
234 |
$7K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
125 |
103 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
48 |
44 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
485 |
474 |
$4K |
| D1206 |
Topical application of fluoride varnish |
305 |
295 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
156 |
72 |
$2K |
| 81002 |
|
1,017 |
942 |
$1K |
| 85018 |
|
1,247 |
1,188 |
$721.96 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
35 |
$496.22 |
| 87807 |
|
35 |
31 |
$413.54 |
| 80061 |
Lipid panel |
14 |
12 |
$181.83 |
| 92551 |
|
317 |
300 |
$13.00 |
| 90688 |
|
258 |
246 |
$0.00 |
| 90647 |
|
117 |
113 |
$0.00 |
| 81000 |
|
90 |
89 |
$0.00 |
| 90651 |
|
32 |
27 |
$0.00 |
| 90723 |
|
85 |
83 |
$0.00 |
| 88738 |
|
21 |
21 |
$0.00 |
| 99173 |
|
379 |
363 |
$0.00 |
| 90633 |
|
34 |
32 |
$0.00 |
| 90670 |
|
168 |
161 |
$0.00 |
| 90687 |
|
46 |
43 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |