| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,833 |
6,472 |
$772K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,986 |
1,440 |
$210K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,524 |
1,079 |
$175K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,405 |
1,082 |
$149K |
| Q3014 |
Telehealth originating site facility fee |
5,359 |
3,802 |
$76K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
714 |
615 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
484 |
433 |
$53K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
779 |
725 |
$43K |
| D1206 |
Topical application of fluoride varnish |
1,366 |
1,312 |
$33K |
| 90686 |
|
1,174 |
1,114 |
$26K |
| 97803 |
|
2,214 |
1,944 |
$24K |
| 96127 |
|
3,502 |
3,351 |
$23K |
| 90670 |
|
460 |
446 |
$11K |
| 99401 |
|
327 |
279 |
$10K |
| 90651 |
|
275 |
261 |
$6K |
| 90734 |
|
260 |
240 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
594 |
562 |
$5K |
| 90647 |
|
227 |
221 |
$5K |
| 0071A |
|
134 |
128 |
$5K |
| 99173 |
|
1,792 |
1,729 |
$5K |
| 2015F |
|
662 |
594 |
$4K |
| 0072A |
|
110 |
108 |
$4K |
| 90723 |
|
187 |
180 |
$4K |
| 0002A |
|
107 |
105 |
$4K |
| 90633 |
|
188 |
178 |
$4K |
| 0001A |
|
86 |
86 |
$3K |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
618 |
560 |
$3K |
| 96160 |
|
956 |
866 |
$3K |
| 90710 |
|
107 |
105 |
$2K |
| 90620 |
|
93 |
82 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
18 |
12 |
$2K |
| 0003A |
|
56 |
52 |
$2K |
| 94760 |
|
1,711 |
1,569 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
107 |
53 |
$1K |
| 90715 |
|
61 |
58 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
19 |
15 |
$1K |
| 0073A |
|
29 |
28 |
$1K |
| 97802 |
|
42 |
42 |
$690.71 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
54 |
$673.09 |
| 96161 |
|
229 |
209 |
$631.22 |
| 90696 |
|
26 |
26 |
$605.28 |
| 90700 |
|
15 |
15 |
$349.20 |
| 94150 |
|
31 |
27 |
$201.80 |
| 99051 |
|
13 |
13 |
$107.04 |
| 99000 |
|
441 |
412 |
$61.47 |
| 91307 |
|
71 |
67 |
$40.48 |
| 36416 |
|
333 |
303 |
$31.50 |
| 91300 |
|
92 |
80 |
$0.00 |