| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,375 |
1,370 |
$9K |
| 90791 |
Psychiatric diagnostic evaluation |
43 |
43 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,300 |
1,232 |
$1K |
| 99173 |
|
648 |
648 |
$937.69 |
| 85018 |
|
770 |
769 |
$837.16 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,626 |
2,539 |
$735.95 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
116 |
116 |
$416.28 |
| 90686 |
|
205 |
205 |
$286.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
199 |
199 |
$175.40 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
133 |
133 |
$112.17 |
| 92551 |
|
667 |
666 |
$101.68 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$83.88 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
950 |
839 |
$55.95 |
| 90647 |
|
92 |
92 |
$21.60 |
| 90656 |
|
332 |
332 |
$10.80 |
| 90723 |
|
48 |
48 |
$0.00 |
| 90680 |
|
29 |
29 |
$0.00 |
| 91301 |
|
14 |
14 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
15 |
15 |
$0.00 |
| 0011A |
|
14 |
14 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
188 |
187 |
$0.00 |
| 90670 |
|
68 |
68 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
73 |
73 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
52 |
52 |
$0.00 |
| 90734 |
|
16 |
16 |
$0.00 |
| 92552 |
|
18 |
18 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |