| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,134 |
9,291 |
$689K |
| 99199 |
Unlisted special service, procedure or report |
80,293 |
45,454 |
$477K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,266 |
1,926 |
$206K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,366 |
1,304 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
597 |
457 |
$23K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
808 |
395 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
97 |
79 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
426 |
370 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
170 |
169 |
$5K |
| 96127 |
|
897 |
772 |
$3K |
| 92551 |
|
2,313 |
2,005 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
25 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
37 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
271 |
250 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
48 |
39 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$935.04 |
| 99173 |
|
2,071 |
1,780 |
$891.49 |
| 90686 |
|
661 |
592 |
$754.49 |
| 99442 |
|
13 |
12 |
$710.21 |
| D0145 |
Oral evaluation for a patient under three years of age |
26 |
25 |
$477.02 |
| 96160 |
|
137 |
123 |
$463.30 |
| D1206 |
Topical application of fluoride varnish |
26 |
25 |
$210.60 |
| 90670 |
|
12 |
12 |
$0.00 |
| 99174 |
|
12 |
12 |
$0.00 |