| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,675 |
7,601 |
$964K |
| 99199 |
Unlisted special service, procedure or report |
115,515 |
54,542 |
$874K |
| 99215 |
Prolong outpt/office vis |
5,817 |
4,212 |
$705K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,553 |
2,045 |
$227K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,711 |
2,151 |
$225K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,692 |
1,240 |
$145K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,303 |
2,564 |
$124K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,105 |
3,876 |
$85K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,460 |
1,184 |
$46K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,668 |
2,486 |
$42K |
| 96127 |
|
7,047 |
4,908 |
$25K |
| D1206 |
Topical application of fluoride varnish |
1,451 |
1,176 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
189 |
137 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
518 |
500 |
$10K |
| 94150 |
|
967 |
730 |
$8K |
| 96160 |
|
2,300 |
1,772 |
$8K |
| 81003 |
|
4,400 |
3,265 |
$6K |
| 90670 |
|
2,091 |
1,637 |
$5K |
| 99381 |
|
35 |
32 |
$4K |
| 92551 |
|
3,554 |
2,695 |
$3K |
| 94664 |
|
282 |
229 |
$3K |
| 90461 |
|
306 |
297 |
$2K |
| 90710 |
|
408 |
312 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
155 |
143 |
$1K |
| 99173 |
|
3,497 |
2,651 |
$827.88 |
| 94010 |
|
36 |
28 |
$821.13 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
40 |
$565.20 |
| 90723 |
|
504 |
422 |
$558.20 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
38 |
25 |
$356.30 |
| 90647 |
|
610 |
500 |
$349.98 |
| 90633 |
|
762 |
617 |
$335.71 |
| 94760 |
|
4,239 |
3,080 |
$301.85 |
| 90697 |
|
54 |
42 |
$268.72 |
| 90700 |
|
64 |
52 |
$26.55 |
| 90680 |
|
1,164 |
922 |
$0.00 |
| 90686 |
|
797 |
652 |
$0.00 |
| 90651 |
|
68 |
49 |
$0.00 |
| 90688 |
|
70 |
49 |
$0.00 |
| 90698 |
|
84 |
76 |
$0.00 |
| 90648 |
|
104 |
88 |
$0.00 |
| 90671 |
|
38 |
37 |
$0.00 |
| 90685 |
|
138 |
127 |
$0.00 |