| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
60,524 |
37,971 |
$354K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
970 |
697 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,472 |
1,011 |
$41K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
189 |
134 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
156 |
117 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
128 |
85 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
119 |
65 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
361 |
248 |
$3K |
| D1206 |
Topical application of fluoride varnish |
188 |
104 |
$1K |
| D0145 |
Oral evaluation for a patient under three years of age |
57 |
35 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
142 |
121 |
$564.70 |
| 92551 |
|
323 |
220 |
$539.34 |
| 99173 |
|
498 |
344 |
$510.20 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
117 |
74 |
$480.42 |
| 90461 |
|
179 |
106 |
$473.39 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
102 |
68 |
$395.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
272 |
179 |
$341.71 |
| 96127 |
|
34 |
26 |
$191.25 |
| 90660 |
|
17 |
16 |
$101.76 |
| 90688 |
|
13 |
13 |
$0.00 |
| 90686 |
|
141 |
113 |
$0.00 |
| 3008F |
|
74 |
62 |
$0.00 |
| 90651 |
|
16 |
14 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
32 |
32 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
36 |
36 |
$0.00 |
| 90671 |
|
44 |
14 |
$0.00 |
| 90633 |
|
30 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
36 |
25 |
$0.00 |