| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,874 |
1,646 |
$109K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
525 |
504 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
526 |
503 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
272 |
264 |
$18K |
| 90698 |
|
306 |
300 |
$8K |
| 90670 |
|
322 |
319 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
18 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
55 |
53 |
$718.25 |
| 90680 |
|
130 |
130 |
$706.72 |
| 90686 |
|
120 |
120 |
$669.35 |
| D1206 |
Topical application of fluoride varnish |
25 |
25 |
$380.65 |
| 99188 |
|
24 |
24 |
$366.15 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
17 |
13 |
$345.12 |
| 90633 |
|
58 |
57 |
$308.58 |
| 90744 |
|
26 |
26 |
$141.65 |
| 90685 |
|
17 |
16 |
$88.06 |