| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
821 |
681 |
$97K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
456 |
380 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
22 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
16 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
38 |
37 |
$2K |
| 99401 |
|
584 |
464 |
$2K |
| D1206 |
Topical application of fluoride varnish |
37 |
37 |
$501.00 |
| 92553 |
|
456 |
339 |
$350.09 |
| 86703 |
|
60 |
46 |
$77.77 |
| 87070 |
|
21 |
18 |
$48.86 |
| 81001 |
|
130 |
100 |
$38.55 |
| 36415 |
Collection of venous blood by venipuncture |
416 |
351 |
$36.45 |
| 85018 |
|
992 |
793 |
$26.88 |
| 86592 |
|
39 |
30 |
$6.92 |
| 3008F |
|
799 |
613 |
$0.00 |
| 92551 |
|
16 |
12 |
$0.00 |
| 3351F |
|
344 |
277 |
$0.00 |
| 92567 |
|
235 |
220 |
$0.00 |
| 1126F |
|
163 |
132 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
74 |
69 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
16 |
12 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
60 |
43 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
31 |
26 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14 |
13 |
$0.00 |
| 90651 |
|
15 |
13 |
$0.00 |
| 99173 |
|
1,078 |
878 |
$0.00 |
| 81003 |
|
121 |
73 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
93 |
90 |
$0.00 |
| 81025 |
|
107 |
85 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
60 |
43 |
$0.00 |
| 99408 |
|
59 |
57 |
$0.00 |
| 81002 |
|
288 |
256 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
31 |
29 |
$0.00 |
| 3725F |
|
104 |
91 |
$0.00 |