| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
142,976 |
77,387 |
$1.04M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,311 |
2,358 |
$187K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,215 |
1,023 |
$53K |
| 99401 |
|
748 |
479 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
117 |
98 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
121 |
100 |
$8K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
22 |
17 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,251 |
898 |
$2K |
| 81002 |
|
1,091 |
782 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
12 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
91 |
78 |
$2K |
| 81025 |
|
118 |
78 |
$585.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
18 |
16 |
$552.15 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
30 |
15 |
$513.10 |
| 92551 |
|
1,092 |
859 |
$338.56 |
| 81003 |
|
278 |
165 |
$232.68 |
| 71045 |
Radiologic examination, chest; single view |
14 |
14 |
$227.36 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
25 |
$161.31 |
| 99173 |
|
1,094 |
860 |
$27.36 |
| 94760 |
|
35 |
29 |
$4.14 |
| 90633 |
|
15 |
13 |
$0.00 |
| 98966 |
|
14 |
12 |
$0.00 |