| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,067 |
13,803 |
$475K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,251 |
4,963 |
$130K |
| 99215 |
Prolong outpt/office vis |
2,991 |
2,696 |
$117K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,784 |
2,759 |
$88K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,292 |
2,281 |
$85K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,884 |
5,791 |
$70K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,760 |
1,743 |
$51K |
| 92552 |
|
4,011 |
3,983 |
$31K |
| 90651 |
|
620 |
613 |
$22K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,254 |
2,163 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
377 |
366 |
$14K |
| 85018 |
|
7,132 |
7,038 |
$13K |
| 86580 |
|
2,524 |
2,511 |
$11K |
| 90688 |
|
3,078 |
3,053 |
$10K |
| 99173 |
|
4,350 |
4,322 |
$8K |
| 90734 |
|
467 |
463 |
$7K |
| 90670 |
|
701 |
699 |
$7K |
| 99188 |
|
382 |
376 |
$6K |
| D1206 |
Topical application of fluoride varnish |
489 |
489 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
196 |
192 |
$4K |
| 90621 |
|
41 |
41 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,039 |
1,022 |
$3K |
| 87430 |
|
371 |
362 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
341 |
328 |
$2K |
| 0071A |
|
197 |
195 |
$2K |
| 0124A |
|
53 |
53 |
$1K |
| 90685 |
|
353 |
351 |
$1K |
| 0003A |
|
36 |
36 |
$924.00 |
| 90698 |
|
323 |
321 |
$796.14 |
| 0072A |
|
189 |
189 |
$712.00 |
| 90680 |
|
103 |
99 |
$570.54 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
106 |
104 |
$566.16 |
| 90715 |
|
58 |
57 |
$531.48 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,731 |
2,684 |
$445.50 |
| 0053A |
|
18 |
18 |
$396.00 |
| 88738 |
|
135 |
133 |
$300.68 |
| 0073A |
|
27 |
27 |
$228.00 |
| 90710 |
|
108 |
108 |
$227.00 |
| 0074A |
|
39 |
39 |
$210.00 |
| 0004A |
|
18 |
18 |
$168.00 |
| 90744 |
|
52 |
52 |
$159.75 |
| 90633 |
|
149 |
149 |
$150.92 |
| 90697 |
|
16 |
16 |
$146.55 |
| 0054A |
|
12 |
12 |
$84.00 |
| 91319 |
|
46 |
46 |
$80.01 |
| 90658 |
|
12 |
12 |
$78.96 |
| 90656 |
|
211 |
211 |
$70.44 |
| 91320 |
|
86 |
86 |
$50.04 |
| 81002 |
|
40 |
37 |
$41.62 |
| 0001A |
|
26 |
26 |
$40.00 |
| 90700 |
|
12 |
12 |
$30.17 |
| 99401 |
|
28 |
28 |
$25.88 |
| 90677 |
|
12 |
12 |
$18.00 |
| 90686 |
|
173 |
171 |
$9.00 |
| 90461 |
|
544 |
541 |
$0.00 |
| 91308 |
|
46 |
42 |
$0.00 |
| 91300 |
|
113 |
111 |
$0.00 |
| 0002A |
|
16 |
15 |
$0.00 |
| 91312 |
|
15 |
15 |
$0.00 |
| 36416 |
|
612 |
610 |
$0.00 |
| 91307 |
|
431 |
385 |
$0.00 |
| 91305 |
|
32 |
32 |
$0.00 |