| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,840 |
2,140 |
$171K |
| 99199 |
Unlisted special service, procedure or report |
28,291 |
17,931 |
$157K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,066 |
915 |
$20K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
139 |
90 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
226 |
99 |
$3K |
| 92551 |
|
410 |
348 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
12 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
75 |
67 |
$781.06 |
| D0145 |
Oral evaluation for a patient under three years of age |
17 |
13 |
$570.15 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
14 |
$470.35 |
| 99173 |
|
377 |
323 |
$339.91 |
| 90686 |
|
445 |
371 |
$267.92 |
| D1206 |
Topical application of fluoride varnish |
17 |
13 |
$251.70 |
| 90656 |
|
75 |
72 |
$0.00 |
| 91307 |
|
36 |
25 |
$0.00 |