| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
555 |
483 |
$44K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
501 |
432 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
496 |
452 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
85 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
219 |
202 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
55 |
48 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
444 |
419 |
$4K |
| D0145 |
Oral evaluation for a patient under three years of age |
53 |
52 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
12 |
$935.04 |
| 90651 |
|
14 |
12 |
$840.96 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
26 |
$812.50 |
| D1206 |
Topical application of fluoride varnish |
53 |
52 |
$762.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$339.12 |
| 90473 |
|
13 |
13 |
$265.85 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
16 |
$226.08 |
| 96127 |
|
13 |
13 |
$106.25 |
| 90686 |
|
118 |
112 |
$66.20 |
| 92551 |
|
279 |
261 |
$32.00 |
| 90672 |
|
15 |
15 |
$23.64 |
| 99173 |
|
280 |
262 |
$21.00 |
| 90685 |
|
27 |
27 |
$0.00 |
| 94760 |
|
286 |
235 |
$0.00 |