| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,100 |
3,738 |
$323K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,060 |
941 |
$119K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
845 |
746 |
$80K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
456 |
402 |
$42K |
| 90686 |
|
1,903 |
1,596 |
$36K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,569 |
2,365 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
252 |
228 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
435 |
405 |
$20K |
| D1206 |
Topical application of fluoride varnish |
694 |
668 |
$17K |
| 96127 |
|
1,605 |
1,362 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
620 |
567 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
540 |
204 |
$6K |
| 90648 |
|
177 |
152 |
$4K |
| 96161 |
|
1,483 |
1,200 |
$3K |
| 88738 |
|
1,087 |
960 |
$3K |
| 90670 |
|
162 |
138 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
583 |
436 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
13 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
127 |
106 |
$997.97 |
| 90680 |
|
53 |
41 |
$954.48 |
| 0071A |
|
27 |
24 |
$883.76 |
| 90723 |
|
37 |
30 |
$698.40 |
| 0072A |
|
14 |
14 |
$521.44 |
| 99051 |
|
67 |
63 |
$432.41 |
| 92558 |
|
421 |
309 |
$394.38 |
| 99177 |
|
50 |
42 |
$201.60 |
| 83655 |
|
12 |
12 |
$142.68 |
| 94760 |
|
80 |
69 |
$83.00 |
| 85018 |
|
12 |
12 |
$24.34 |
| 99000 |
|
74 |
68 |
$0.00 |
| 90461 |
|
40 |
39 |
$0.00 |