| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,528 |
9,486 |
$642K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,137 |
5,564 |
$524K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,313 |
2,285 |
$194K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,874 |
6,626 |
$173K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,019 |
1,993 |
$164K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,665 |
1,617 |
$134K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,352 |
1,329 |
$118K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13,123 |
9,127 |
$114K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,334 |
2,237 |
$98K |
| 99215 |
Prolong outpt/office vis |
801 |
746 |
$94K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
8,560 |
8,197 |
$78K |
| 99051 |
|
5,116 |
4,728 |
$78K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,363 |
1,282 |
$45K |
| 92552 |
|
1,481 |
1,444 |
$36K |
| 99173 |
|
2,985 |
2,904 |
$35K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,254 |
1,208 |
$30K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
828 |
804 |
$23K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,688 |
1,621 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,057 |
1,049 |
$20K |
| 90461 |
|
1,898 |
1,870 |
$20K |
| 92567 |
|
1,760 |
1,696 |
$20K |
| 99188 |
|
691 |
674 |
$18K |
| 96127 |
|
1,501 |
1,299 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
779 |
433 |
$10K |
| 83655 |
|
1,047 |
1,023 |
$10K |
| 94760 |
|
7,018 |
6,229 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
55 |
55 |
$5K |
| 0072A |
|
119 |
119 |
$5K |
| 0071A |
|
107 |
106 |
$4K |
| 87428 |
|
106 |
87 |
$4K |
| 99423 |
|
16 |
13 |
$1K |
| 99460 |
|
12 |
12 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
78 |
77 |
$954.48 |
| 81002 |
|
347 |
308 |
$867.77 |
| 0002A |
|
16 |
16 |
$688.05 |
| 0001A |
|
15 |
15 |
$688.05 |
| 82465 |
|
168 |
159 |
$598.03 |
| 85018 |
|
235 |
230 |
$496.75 |
| 87807 |
|
37 |
37 |
$419.39 |
| 94761 |
|
61 |
59 |
$183.14 |
| 96161 |
|
96 |
91 |
$49.22 |
| 96160 |
|
37 |
36 |
$42.79 |
| D1206 |
Topical application of fluoride varnish |
183 |
179 |
$28.60 |
| 99058 |
|
64 |
64 |
$13.59 |
| 99070 |
|
319 |
303 |
$10.77 |
| 99000 |
|
553 |
499 |
$5.50 |
| 90677 |
|
109 |
107 |
$0.22 |
| 90633 |
|
403 |
397 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90670 |
|
807 |
800 |
$0.00 |
| 99072 |
|
10,883 |
9,129 |
$0.00 |
| 90710 |
|
170 |
169 |
$0.00 |
| 90685 |
|
74 |
74 |
$0.00 |
| 90734 |
|
305 |
302 |
$0.00 |
| 90671 |
|
59 |
59 |
$0.00 |
| 90672 |
|
22 |
22 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90715 |
|
42 |
42 |
$0.00 |
| 90686 |
|
3,304 |
3,260 |
$0.00 |
| 90698 |
|
582 |
574 |
$0.00 |
| 36416 |
|
1,921 |
1,784 |
$0.00 |
| 90744 |
|
219 |
216 |
$0.00 |
| 90651 |
|
223 |
215 |
$0.00 |
| 90680 |
|
484 |
480 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| 91307 |
|
182 |
171 |
$0.00 |