| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,940 |
1,578 |
$148K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
401 |
344 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
297 |
259 |
$23K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
655 |
554 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,086 |
899 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
263 |
226 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
160 |
133 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,190 |
1,017 |
$10K |
| 99215 |
Prolong outpt/office vis |
52 |
46 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
107 |
91 |
$3K |
| 96127 |
|
651 |
572 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
73 |
57 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
17 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$2K |
| 99408 |
|
43 |
42 |
$1K |
| D1206 |
Topical application of fluoride varnish |
73 |
57 |
$949.05 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
17 |
$237.61 |
| 90686 |
|
127 |
82 |
$70.82 |
| 96161 |
|
16 |
16 |
$59.84 |
| 92552 |
|
960 |
829 |
$58.15 |
| 99173 |
|
1,095 |
947 |
$38.00 |
| 85018 |
|
93 |
76 |
$14.60 |
| 90670 |
|
144 |
119 |
$0.00 |
| 90633 |
|
37 |
26 |
$0.00 |
| 36416 |
|
123 |
102 |
$0.00 |
| 99000 |
|
34 |
32 |
$0.00 |
| 94760 |
|
14 |
14 |
$0.00 |
| 90698 |
|
46 |
38 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |