| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
41,583 |
20,595 |
$297K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,688 |
1,251 |
$141K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,039 |
698 |
$61K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,574 |
1,194 |
$26K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
545 |
420 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
212 |
153 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
117 |
95 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
302 |
200 |
$11K |
| 96127 |
|
2,522 |
1,826 |
$9K |
| D0145 |
Oral evaluation for a patient under three years of age |
369 |
272 |
$9K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
153 |
111 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
910 |
672 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
41 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
186 |
138 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
42 |
36 |
$4K |
| D1206 |
Topical application of fluoride varnish |
114 |
81 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
88 |
63 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
28 |
25 |
$845.14 |
| 92552 |
|
1,115 |
800 |
$461.84 |
| 90686 |
|
247 |
184 |
$231.07 |
| 85018 |
|
117 |
78 |
$161.38 |
| 96160 |
|
37 |
28 |
$119.83 |
| 99173 |
|
1,214 |
935 |
$101.42 |
| 83718 |
|
15 |
12 |
$55.80 |
| 82465 |
|
15 |
12 |
$32.27 |
| 36416 |
|
176 |
136 |
$0.00 |
| 90656 |
|
14 |
14 |
$0.00 |
| 90619 |
|
26 |
12 |
$0.00 |