| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,709 |
9,689 |
$596K |
| 99199 |
Unlisted special service, procedure or report |
64,872 |
52,215 |
$224K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,721 |
1,434 |
$117K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,900 |
2,938 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
460 |
385 |
$40K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
965 |
762 |
$35K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
344 |
301 |
$28K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,446 |
692 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
224 |
162 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
489 |
409 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
109 |
100 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
486 |
340 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
398 |
294 |
$4K |
| 99401 |
|
128 |
73 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
151 |
142 |
$1K |
| D0145 |
Oral evaluation for a patient under three years of age |
29 |
27 |
$988.26 |
| 90651 |
|
36 |
27 |
$654.48 |
| 90686 |
|
1,062 |
835 |
$588.67 |
| 99173 |
|
1,042 |
855 |
$508.81 |
| D1206 |
Topical application of fluoride varnish |
29 |
27 |
$436.28 |
| 90688 |
|
56 |
35 |
$376.05 |
| 90474 |
|
12 |
12 |
$245.40 |
| 92551 |
|
248 |
202 |
$141.94 |
| 36415 |
Collection of venous blood by venipuncture |
54 |
39 |
$91.80 |
| 90734 |
|
35 |
18 |
$0.00 |
| 90670 |
|
29 |
28 |
$0.00 |
| 90685 |
|
17 |
14 |
$0.00 |
| 90698 |
|
29 |
28 |
$0.00 |
| 3008F |
|
334 |
283 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |