| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
40,522 |
23,995 |
$236K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,309 |
1,877 |
$218K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,852 |
2,214 |
$181K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
520 |
443 |
$51K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
512 |
441 |
$49K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,612 |
2,152 |
$48K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,035 |
863 |
$41K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,111 |
926 |
$37K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,556 |
2,240 |
$23K |
| D0145 |
Oral evaluation for a patient under three years of age |
258 |
237 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
239 |
200 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
50 |
46 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
51 |
48 |
$5K |
| D1206 |
Topical application of fluoride varnish |
258 |
237 |
$4K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
98 |
75 |
$4K |
| 92551 |
|
1,734 |
1,481 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
163 |
140 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
59 |
47 |
$2K |
| 99173 |
|
1,715 |
1,463 |
$2K |
| 90473 |
|
81 |
73 |
$1K |
| 96127 |
|
125 |
108 |
$783.16 |
| 90686 |
|
1,032 |
845 |
$164.81 |
| 90672 |
|
246 |
192 |
$47.28 |
| 91307 |
|
23 |
14 |
$0.00 |
| 90651 |
|
17 |
12 |
$0.00 |
| 90670 |
|
26 |
25 |
$0.00 |