| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,697 |
8,477 |
$490K |
| 0502F |
|
2,521 |
1,366 |
$110K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,029 |
935 |
$78K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
780 |
646 |
$60K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
832 |
640 |
$57K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
523 |
484 |
$43K |
| H1000 |
Prenatal care, at-risk assessment |
2,533 |
1,438 |
$37K |
| 92551 |
|
1,855 |
1,646 |
$28K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
327 |
294 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,720 |
1,451 |
$27K |
| D1206 |
Topical application of fluoride varnish |
652 |
564 |
$16K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
148 |
138 |
$12K |
| 99173 |
|
1,721 |
1,567 |
$12K |
| 96160 |
|
654 |
587 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
376 |
352 |
$6K |
| 81002 |
|
2,089 |
1,200 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
30 |
$4K |
| 90700 |
|
481 |
413 |
$3K |
| 99401 |
|
90 |
76 |
$3K |
| 90713 |
|
284 |
242 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29 |
27 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
15 |
13 |
$1K |
| 90670 |
|
95 |
79 |
$813.11 |
| 90647 |
|
101 |
91 |
$646.40 |
| 90734 |
|
85 |
71 |
$531.20 |
| 90744 |
|
64 |
54 |
$409.60 |
| 90715 |
|
55 |
45 |
$339.20 |
| 90649 |
|
52 |
49 |
$332.80 |
| 90716 |
|
32 |
28 |
$204.80 |
| 90707 |
|
32 |
28 |
$204.80 |