| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,418 |
2,245 |
$192K |
| 99375 |
|
1,440 |
1,332 |
$118K |
| 99199 |
Unlisted special service, procedure or report |
21,383 |
12,608 |
$99K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,692 |
1,706 |
$92K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
221 |
162 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,143 |
785 |
$13K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
295 |
122 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
193 |
147 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,520 |
1,082 |
$8K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
254 |
189 |
$5K |
| 87631 |
|
66 |
56 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
91 |
55 |
$4K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
67 |
57 |
$3K |
| 99215 |
Prolong outpt/office vis |
17 |
16 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
43 |
28 |
$1K |
| D1206 |
Topical application of fluoride varnish |
91 |
69 |
$821.30 |
| 96127 |
|
390 |
268 |
$702.08 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
22 |
12 |
$615.72 |
| 92552 |
|
183 |
130 |
$602.05 |
| 99173 |
|
657 |
477 |
$349.56 |
| 90686 |
|
361 |
236 |
$217.25 |
| 90474 |
|
12 |
12 |
$216.80 |
| 90680 |
|
14 |
12 |
$83.81 |
| 92551 |
|
97 |
63 |
$69.07 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17 |
17 |
$42.94 |
| 99072 |
|
456 |
225 |
$0.00 |
| 90670 |
|
40 |
38 |
$0.00 |
| 99174 |
|
48 |
19 |
$0.00 |