| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
33,032 |
24,815 |
$161K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,111 |
861 |
$85K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,138 |
910 |
$63K |
| 99058 |
|
600 |
458 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
444 |
375 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
79 |
73 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
37 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
97 |
74 |
$4K |
| 99215 |
Prolong outpt/office vis |
67 |
37 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
205 |
89 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
41 |
41 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
83 |
71 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
67 |
62 |
$602.79 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
14 |
$374.87 |
| 99050 |
|
12 |
12 |
$317.76 |
| 90686 |
|
111 |
95 |
$35.64 |
| 92551 |
|
230 |
212 |
$8.02 |
| 3078F |
|
154 |
116 |
$5.98 |
| 1160F |
|
234 |
179 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 1036F |
|
147 |
111 |
$0.00 |
| 99172 |
|
221 |
200 |
$0.00 |
| 3008F |
|
208 |
159 |
$0.00 |
| 3074F |
|
150 |
113 |
$0.00 |
| 99000 |
|
40 |
23 |
$0.00 |