| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,518 |
1,417 |
$77K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
586 |
510 |
$44K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
408 |
382 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
901 |
879 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
615 |
570 |
$12K |
| 99199 |
Unlisted special service, procedure or report |
1,834 |
924 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
128 |
124 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
113 |
106 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
92 |
84 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
370 |
231 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
64 |
54 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
451 |
408 |
$4K |
| D0145 |
Oral evaluation for a patient under three years of age |
96 |
91 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
47 |
44 |
$1K |
| D1206 |
Topical application of fluoride varnish |
96 |
91 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
107 |
85 |
$890.94 |
| 96127 |
|
70 |
66 |
$267.75 |
| 90474 |
|
13 |
13 |
$265.85 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
17 |
17 |
$173.06 |
| 90686 |
|
78 |
73 |
$67.86 |
| 92551 |
|
389 |
360 |
$11.02 |
| 99173 |
|
349 |
326 |
$3.00 |
| 90723 |
|
13 |
13 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90670 |
|
55 |
54 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |