| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,922 |
4,937 |
$367K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,124 |
1,008 |
$102K |
| 99199 |
Unlisted special service, procedure or report |
16,979 |
13,207 |
$69K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
517 |
481 |
$46K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,493 |
2,180 |
$46K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
842 |
759 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
199 |
191 |
$21K |
| 99441 |
|
675 |
457 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
379 |
310 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
185 |
168 |
$15K |
| 99401 |
|
435 |
314 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
318 |
302 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
304 |
145 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
32 |
28 |
$3K |
| 0072A |
|
56 |
37 |
$2K |
| 96127 |
|
512 |
470 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
114 |
76 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
424 |
393 |
$2K |
| 0071A |
|
45 |
28 |
$2K |
| 90686 |
|
799 |
668 |
$939.67 |
| 90651 |
|
19 |
15 |
$630.72 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
21 |
15 |
$533.82 |
| D0145 |
Oral evaluation for a patient under three years of age |
20 |
13 |
$518.83 |
| 92551 |
|
420 |
396 |
$400.13 |
| 99173 |
|
2,134 |
1,896 |
$349.02 |
| 91037 |
|
151 |
97 |
$311.64 |
| 96161 |
|
176 |
162 |
$285.56 |
| 90734 |
|
18 |
13 |
$252.52 |
| D1206 |
Topical application of fluoride varnish |
20 |
13 |
$229.06 |
| 90633 |
|
13 |
13 |
$32.14 |
| 85018 |
|
14 |
12 |
$14.60 |
| 96160 |
|
66 |
62 |
$11.22 |