| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,201 |
8,658 |
$623K |
| 99199 |
Unlisted special service, procedure or report |
122,525 |
60,996 |
$611K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,339 |
4,782 |
$449K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,790 |
3,432 |
$367K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,816 |
2,516 |
$257K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,155 |
1,900 |
$190K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,204 |
7,282 |
$158K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
814 |
706 |
$79K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
9,183 |
6,966 |
$74K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
160 |
143 |
$17K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
146 |
125 |
$15K |
| D0145 |
Oral evaluation for a patient under three years of age |
315 |
291 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
614 |
259 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
176 |
121 |
$6K |
| 87428 |
|
122 |
86 |
$5K |
| D1206 |
Topical application of fluoride varnish |
316 |
291 |
$5K |
| 90474 |
|
240 |
238 |
$5K |
| 92551 |
|
608 |
530 |
$4K |
| 96161 |
|
1,047 |
901 |
$4K |
| 90686 |
|
2,282 |
1,908 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
110 |
90 |
$1K |
| 99050 |
|
62 |
53 |
$1K |
| 99173 |
|
847 |
774 |
$1K |
| 96127 |
|
252 |
209 |
$987.89 |
| 83655 |
|
63 |
51 |
$771.18 |
| 99177 |
|
1,013 |
860 |
$506.34 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
20 |
18 |
$483.84 |
| 85018 |
|
131 |
113 |
$93.07 |
| 90656 |
|
234 |
218 |
$42.94 |
| 90660 |
|
14 |
12 |
$25.44 |
| 90670 |
|
1,637 |
1,452 |
$0.00 |
| 90648 |
|
1,044 |
878 |
$0.00 |
| 90707 |
|
49 |
36 |
$0.00 |
| 99072 |
|
5,072 |
3,915 |
$0.00 |
| 90633 |
|
70 |
64 |
$0.00 |
| 90685 |
|
126 |
125 |
$0.00 |
| 90680 |
|
587 |
514 |
$0.00 |
| 90723 |
|
433 |
355 |
$0.00 |
| 99000 |
|
202 |
180 |
$0.00 |
| 36416 |
|
201 |
170 |
$0.00 |
| 90677 |
|
98 |
97 |
$0.00 |
| 90698 |
|
260 |
258 |
$0.00 |
| 90716 |
|
27 |
24 |
$0.00 |
| 90744 |
|
15 |
15 |
$0.00 |