| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,757 |
4,543 |
$324K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,632 |
2,350 |
$271K |
| 99199 |
Unlisted special service, procedure or report |
22,596 |
22,411 |
$78K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,589 |
1,850 |
$78K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,045 |
1,298 |
$64K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,589 |
1,284 |
$44K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,967 |
2,030 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
408 |
339 |
$33K |
| 87428 |
|
569 |
436 |
$31K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
864 |
769 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
384 |
289 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
365 |
269 |
$25K |
| 99215 |
Prolong outpt/office vis |
130 |
82 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
115 |
95 |
$9K |
| 99401 |
|
439 |
256 |
$8K |
| 96127 |
|
1,030 |
775 |
$4K |
| 87807 |
|
141 |
96 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,154 |
865 |
$438.16 |
| D0145 |
Oral evaluation for a patient under three years of age |
32 |
28 |
$389.33 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
29 |
24 |
$274.86 |
| 90734 |
|
118 |
78 |
$263.24 |
| 90651 |
|
13 |
12 |
$210.24 |
| 96160 |
|
97 |
67 |
$201.70 |
| D1206 |
Topical application of fluoride varnish |
32 |
28 |
$171.87 |
| 81002 |
|
66 |
49 |
$138.91 |
| 92587 |
|
1,320 |
1,031 |
$128.17 |
| 90686 |
|
682 |
485 |
$106.44 |
| 99173 |
|
1,354 |
1,045 |
$68.00 |
| 85018 |
|
29 |
24 |
$44.54 |
| 90680 |
|
14 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
60 |
40 |
$0.00 |
| 90647 |
|
40 |
36 |
$0.00 |
| 90688 |
|
23 |
14 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
2,413 |
1,397 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
403 |
253 |
$0.00 |
| 90685 |
|
61 |
53 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
108 |
85 |
$0.00 |
| 90672 |
|
35 |
32 |
$0.00 |
| 90633 |
|
29 |
13 |
$0.00 |
| 90670 |
|
112 |
73 |
$0.00 |