| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
478 |
435 |
$42K |
| 99199 |
Unlisted special service, procedure or report |
4,325 |
2,295 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
337 |
301 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
143 |
133 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
114 |
107 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
103 |
99 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
369 |
353 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
229 |
222 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
63 |
59 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
295 |
266 |
$2K |
| 96127 |
|
498 |
455 |
$2K |
| 99408 |
|
19 |
17 |
$438.44 |
| 85018 |
|
179 |
167 |
$349.58 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$342.54 |
| 81003 |
|
172 |
165 |
$225.99 |
| 96161 |
|
26 |
25 |
$78.89 |
| 83655 |
|
14 |
13 |
$44.79 |
| 92552 |
|
392 |
371 |
$16.15 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90656 |
|
15 |
14 |
$0.00 |
| 90619 |
|
35 |
34 |
$0.00 |
| 90677 |
|
36 |
34 |
$0.00 |
| 90651 |
|
27 |
26 |
$0.00 |
| 99173 |
|
424 |
398 |
$0.00 |
| 90715 |
|
19 |
17 |
$0.00 |
| 90710 |
|
16 |
16 |
$0.00 |
| 90633 |
|
15 |
15 |
$0.00 |
| 90621 |
|
16 |
14 |
$0.00 |