| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,984 |
10,320 |
$597K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,549 |
1,477 |
$114K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,355 |
1,253 |
$111K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,536 |
1,064 |
$97K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,224 |
930 |
$87K |
| 17110 |
|
980 |
967 |
$71K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
719 |
663 |
$58K |
| 92551 |
|
3,632 |
3,310 |
$55K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,255 |
2,500 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
648 |
471 |
$49K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
340 |
313 |
$28K |
| 99173 |
|
3,264 |
3,029 |
$23K |
| D1206 |
Topical application of fluoride varnish |
843 |
669 |
$22K |
| 96160 |
|
835 |
717 |
$12K |
| 0502F |
|
229 |
117 |
$11K |
| H1000 |
Prenatal care, at-risk assessment |
544 |
250 |
$8K |
| 90700 |
|
460 |
349 |
$4K |
| 90713 |
|
273 |
208 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
73 |
72 |
$3K |
| 90670 |
|
275 |
211 |
$2K |
| 90734 |
|
122 |
118 |
$2K |
| 90647 |
|
167 |
128 |
$1K |
| 81002 |
|
452 |
274 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
13 |
$1K |
| 90744 |
|
102 |
71 |
$940.68 |
| 90715 |
|
61 |
56 |
$802.41 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
46 |
43 |
$722.20 |
| 90686 |
|
99 |
98 |
$652.63 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
33 |
33 |
$420.98 |
| 87400 |
|
40 |
40 |
$339.20 |
| 90680 |
|
28 |
13 |
$314.24 |
| 87430 |
|
13 |
13 |
$204.10 |