| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
88,724 |
31,805 |
$499K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,918 |
4,493 |
$450K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,475 |
6,363 |
$410K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,751 |
2,119 |
$95K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,411 |
976 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
249 |
188 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
211 |
179 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,873 |
1,363 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
980 |
429 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
556 |
499 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
92 |
91 |
$8K |
| 99070 |
|
1,595 |
1,102 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
107 |
105 |
$4K |
| 92551 |
|
1,899 |
1,382 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
134 |
125 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
15 |
$2K |
| 90686 |
|
1,495 |
1,108 |
$1K |
| 99401 |
|
84 |
40 |
$574.50 |
| D0145 |
Oral evaluation for a patient under three years of age |
41 |
37 |
$418.06 |
| 90473 |
|
13 |
12 |
$224.95 |
| D1206 |
Topical application of fluoride varnish |
41 |
37 |
$184.53 |
| 99173 |
|
2,262 |
1,698 |
$125.85 |
| 96127 |
|
24 |
24 |
$102.00 |
| 96160 |
|
34 |
30 |
$74.80 |
| 94760 |
|
104 |
80 |
$70.38 |
| G9920 |
Screening performed and negative |
1,105 |
906 |
$5.00 |
| 90685 |
|
42 |
32 |
$0.00 |
| 99072 |
|
36 |
16 |
$0.00 |
| 90670 |
|
14 |
14 |
$0.00 |
| 36416 |
|
25 |
25 |
$0.00 |
| 90656 |
|
26 |
14 |
$0.00 |