| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
37,246 |
18,392 |
$228K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,068 |
1,587 |
$176K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,109 |
1,699 |
$123K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,194 |
982 |
$20K |
| 87430 |
|
553 |
481 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
96 |
71 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
214 |
175 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
284 |
248 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
14 |
$979.96 |
| 96127 |
|
278 |
227 |
$944.33 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
29 |
$847.80 |
| 81000 |
|
184 |
147 |
$370.94 |
| 81003 |
|
99 |
78 |
$217.27 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
13 |
$211.95 |
| 85018 |
|
58 |
49 |
$148.70 |
| 90686 |
|
303 |
266 |
$38.75 |
| 90670 |
|
40 |
37 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |