| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,544 |
3,216 |
$33K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,455 |
1,447 |
$20K |
| D1206 |
Topical application of fluoride varnish |
399 |
397 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
949 |
889 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
885 |
832 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
284 |
276 |
$3K |
| 85018 |
|
1,146 |
1,145 |
$2K |
| 92551 |
|
620 |
620 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
276 |
276 |
$2K |
| 99173 |
|
552 |
552 |
$2K |
| 81003 |
|
761 |
757 |
$1K |
| 90656 |
|
228 |
227 |
$693.00 |
| 99381 |
|
15 |
14 |
$634.62 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
71 |
71 |
$543.35 |
| 90686 |
|
93 |
93 |
$495.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
436 |
432 |
$482.37 |
| 86580 |
|
115 |
115 |
$375.87 |
| 90670 |
|
266 |
266 |
$356.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
31 |
$289.84 |
| 90651 |
|
157 |
157 |
$226.80 |
| 90698 |
|
181 |
181 |
$222.25 |
| 90744 |
|
131 |
131 |
$126.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
120 |
115 |
$84.25 |
| 90680 |
|
157 |
157 |
$72.00 |
| 90734 |
|
92 |
92 |
$54.00 |
| 90633 |
|
191 |
191 |
$45.00 |
| 90710 |
|
83 |
83 |
$36.00 |
| 90715 |
|
53 |
53 |
$36.00 |
| 90685 |
|
77 |
77 |
$27.90 |
| 90700 |
|
52 |
52 |
$27.00 |
| 90696 |
|
65 |
65 |
$18.00 |
| 90716 |
|
49 |
49 |
$9.00 |
| 90688 |
|
33 |
33 |
$9.00 |
| 90707 |
|
45 |
45 |
$9.00 |
| 90648 |
|
12 |
12 |
$0.00 |