| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,111 |
1,458 |
$160K |
| 99199 |
Unlisted special service, procedure or report |
25,345 |
15,582 |
$147K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,395 |
930 |
$72K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,427 |
944 |
$20K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,198 |
462 |
$14K |
| 97802 |
|
1,310 |
757 |
$11K |
| 92587 |
|
438 |
297 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
106 |
56 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
190 |
129 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
446 |
361 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
765 |
510 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
180 |
127 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
32 |
$3K |
| 88738 |
|
675 |
315 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 92551 |
|
170 |
95 |
$682.58 |
| 0072A |
|
16 |
12 |
$553.57 |
| 85018 |
|
752 |
579 |
$479.80 |
| 81002 |
|
482 |
288 |
$394.54 |
| 92558 |
|
656 |
537 |
$306.72 |
| 87807 |
|
16 |
14 |
$197.82 |
| 99177 |
|
1,372 |
863 |
$127.89 |
| 90686 |
|
401 |
270 |
$57.21 |
| 99173 |
|
51 |
34 |
$56.62 |
| 99000 |
|
3,223 |
2,014 |
$0.00 |
| 91307 |
|
51 |
30 |
$0.00 |
| 36416 |
|
27 |
16 |
$0.00 |