| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
507 |
467 |
$40K |
| 99215 |
Prolong outpt/office vis |
150 |
140 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
387 |
377 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
96 |
96 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
83 |
81 |
$6K |
| 69210 |
|
144 |
141 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
65 |
65 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
124 |
124 |
$3K |
| D0145 |
Oral evaluation for a patient under three years of age |
84 |
84 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
200 |
97 |
$3K |
| D1206 |
Topical application of fluoride varnish |
84 |
84 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
84 |
84 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
148 |
122 |
$1K |
| 99051 |
|
36 |
35 |
$926.80 |
| 94010 |
|
30 |
28 |
$767.40 |
| 90651 |
|
41 |
41 |
$527.61 |
| 94664 |
|
44 |
42 |
$478.59 |
| 96127 |
|
97 |
97 |
$412.25 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
25 |
25 |
$398.00 |
| 92587 |
|
78 |
78 |
$350.16 |
| 81003 |
|
71 |
68 |
$196.14 |
| 90686 |
|
211 |
210 |
$72.84 |
| 92551 |
|
155 |
155 |
$20.02 |
| 99173 |
|
205 |
205 |
$7.00 |
| 90647 |
|
25 |
25 |
$0.00 |
| 90670 |
|
58 |
58 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |
| 90700 |
|
15 |
15 |
$0.00 |
| 90633 |
|
26 |
26 |
$0.00 |