| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19,217 |
16,653 |
$1.03M |
| 99199 |
Unlisted special service, procedure or report |
92,893 |
46,764 |
$367K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,955 |
1,694 |
$140K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,986 |
5,247 |
$73K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
821 |
735 |
$64K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,785 |
1,629 |
$60K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,486 |
2,186 |
$59K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
804 |
705 |
$58K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,565 |
2,170 |
$44K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
377 |
362 |
$35K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
1,442 |
1,308 |
$15K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
829 |
783 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
65 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
243 |
232 |
$5K |
| 87081 |
|
598 |
564 |
$4K |
| 92551 |
|
2,320 |
2,196 |
$3K |
| 99173 |
|
2,293 |
2,170 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
89 |
61 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
196 |
164 |
$1K |
| 90474 |
|
65 |
61 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
113 |
111 |
$969.45 |
| 90686 |
|
709 |
600 |
$933.55 |
| D1206 |
Topical application of fluoride varnish |
83 |
60 |
$724.04 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
35 |
25 |
$644.46 |
| 71046 |
Radiologic examination, chest; 2 views |
13 |
13 |
$324.22 |
| 90688 |
|
149 |
129 |
$310.65 |
| 90473 |
|
22 |
19 |
$293.08 |
| 90672 |
|
22 |
19 |
$198.56 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
106 |
99 |
$0.00 |
| 90648 |
|
194 |
187 |
$0.00 |
| 90670 |
|
304 |
295 |
$0.00 |
| 90687 |
|
71 |
47 |
$0.00 |
| 3078F |
|
16 |
15 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
2,292 |
2,126 |
$0.00 |
| 90680 |
|
104 |
99 |
$0.00 |
| 90723 |
|
26 |
25 |
$0.00 |
| 90698 |
|
119 |
117 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
162 |
150 |
$0.00 |
| 3074F |
|
33 |
26 |
$0.00 |
| 90656 |
|
53 |
44 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |