| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,940 |
4,190 |
$410K |
| 99199 |
Unlisted special service, procedure or report |
26,954 |
16,836 |
$169K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,233 |
1,128 |
$96K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,118 |
991 |
$84K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,033 |
841 |
$65K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
880 |
782 |
$62K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
646 |
551 |
$44K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,879 |
1,537 |
$40K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,109 |
2,721 |
$38K |
| 99215 |
Prolong outpt/office vis |
282 |
256 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
613 |
550 |
$25K |
| D0145 |
Oral evaluation for a patient under three years of age |
729 |
687 |
$23K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,626 |
2,334 |
$19K |
| 96127 |
|
3,193 |
2,843 |
$12K |
| D1206 |
Topical application of fluoride varnish |
717 |
684 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
256 |
227 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
223 |
210 |
$3K |
| 96160 |
|
339 |
309 |
$1K |
| 96161 |
|
178 |
151 |
$508.64 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
13 |
$367.38 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
110 |
92 |
$293.76 |
| 90649 |
|
165 |
154 |
$164.20 |
| 94664 |
|
14 |
12 |
$133.56 |
| 99070 |
|
13 |
13 |
$122.46 |
| 99173 |
|
1,884 |
1,668 |
$92.35 |
| 85018 |
|
16 |
12 |
$20.44 |
| 90658 |
|
930 |
811 |
$0.02 |
| 90670 |
|
907 |
821 |
$0.00 |
| 90734 |
|
213 |
186 |
$0.00 |
| 90633 |
|
274 |
259 |
$0.00 |
| 90715 |
|
61 |
58 |
$0.00 |
| 90621 |
|
28 |
26 |
$0.00 |
| 90680 |
|
363 |
329 |
$0.00 |
| 99000 |
|
121 |
103 |
$0.00 |
| 90698 |
|
579 |
525 |
$0.00 |
| 90744 |
|
78 |
73 |
$0.00 |
| 90723 |
|
27 |
27 |
$0.00 |
| 90657 |
|
214 |
192 |
$0.00 |
| 87081 |
|
24 |
24 |
$0.00 |
| 3008F |
|
22 |
21 |
$0.00 |