| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,493 |
6,964 |
$798K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,363 |
7,866 |
$671K |
| 99199 |
Unlisted special service, procedure or report |
63,730 |
41,041 |
$362K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,242 |
1,096 |
$117K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,174 |
1,010 |
$108K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,510 |
4,416 |
$100K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
856 |
694 |
$78K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,375 |
1,936 |
$69K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
618 |
515 |
$63K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
878 |
639 |
$31K |
| 87428 |
|
460 |
420 |
$28K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,028 |
804 |
$27K |
| D0145 |
Oral evaluation for a patient under three years of age |
715 |
659 |
$23K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,705 |
1,505 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,210 |
1,074 |
$16K |
| 96127 |
|
3,939 |
3,308 |
$16K |
| 99442 |
|
228 |
207 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
272 |
260 |
$11K |
| 99215 |
Prolong outpt/office vis |
84 |
82 |
$10K |
| D1206 |
Topical application of fluoride varnish |
715 |
659 |
$10K |
| 99401 |
|
276 |
177 |
$9K |
| 90651 |
|
179 |
129 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
296 |
244 |
$3K |
| 90686 |
|
2,097 |
1,698 |
$2K |
| 90734 |
|
58 |
51 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
34 |
26 |
$1K |
| 92551 |
|
3,187 |
2,699 |
$1K |
| 85018 |
|
467 |
395 |
$826.32 |
| 90474 |
|
41 |
39 |
$797.55 |
| 83655 |
|
58 |
55 |
$736.89 |
| 99173 |
|
3,472 |
2,951 |
$684.00 |
| 80061 |
Lipid panel |
37 |
31 |
$538.32 |
| 96161 |
|
349 |
302 |
$485.24 |
| 90619 |
|
68 |
42 |
$476.02 |
| 69210 |
|
15 |
13 |
$466.96 |
| 99441 |
|
13 |
13 |
$407.16 |
| 90670 |
|
482 |
418 |
$232.45 |
| 90715 |
|
35 |
31 |
$210.69 |
| 90698 |
|
214 |
193 |
$108.07 |
| 90633 |
|
180 |
139 |
$32.22 |
| 90677 |
|
62 |
54 |
$0.00 |
| 90744 |
|
69 |
63 |
$0.00 |
| 90680 |
|
55 |
51 |
$0.00 |
| 90696 |
|
30 |
25 |
$0.00 |
| 90710 |
|
196 |
157 |
$0.00 |
| 90685 |
|
24 |
23 |
$0.00 |