| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
88,291 |
51,529 |
$561K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,108 |
7,922 |
$535K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,784 |
5,144 |
$460K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,362 |
1,131 |
$105K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
948 |
746 |
$77K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,418 |
1,851 |
$41K |
| 99058 |
|
2,498 |
2,032 |
$38K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
765 |
579 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
245 |
204 |
$18K |
| 96127 |
|
4,658 |
3,683 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
918 |
762 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,275 |
1,049 |
$11K |
| 99051 |
|
461 |
367 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
466 |
303 |
$6K |
| 92551 |
|
3,599 |
2,863 |
$5K |
| 96161 |
|
1,434 |
1,124 |
$4K |
| 86308 |
|
615 |
516 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
32 |
28 |
$3K |
| 99173 |
|
3,754 |
2,997 |
$2K |
| 82962 |
|
2,044 |
1,072 |
$2K |
| 99215 |
Prolong outpt/office vis |
32 |
27 |
$2K |
| 90734 |
|
109 |
69 |
$1K |
| 90686 |
|
548 |
472 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$1K |
| 99050 |
|
40 |
31 |
$767.92 |
| 90620 |
|
28 |
18 |
$726.68 |
| 86328 |
|
14 |
13 |
$633.22 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
37 |
29 |
$630.90 |
| 99401 |
|
27 |
14 |
$595.77 |
| 92567 |
|
37 |
24 |
$504.68 |
| D0145 |
Oral evaluation for a patient under three years of age |
15 |
13 |
$436.04 |
| 99441 |
|
15 |
13 |
$371.92 |
| D1206 |
Topical application of fluoride varnish |
15 |
13 |
$192.28 |
| 90649 |
|
38 |
17 |
$164.54 |
| 36415 |
Collection of venous blood by venipuncture |
64 |
57 |
$156.60 |
| 81003 |
|
65 |
42 |
$112.90 |
| 1111F |
|
1,306 |
970 |
$0.12 |
| 1030F |
|
90 |
66 |
$0.00 |
| 99000 |
|
165 |
96 |
$0.00 |
| 90651 |
|
17 |
12 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
19 |
17 |
$0.00 |
| 3008F |
|
13 |
13 |
$0.00 |
| 1160F |
|
991 |
693 |
$0.00 |
| 1159F |
|
1,317 |
962 |
$0.00 |
| 90658 |
|
45 |
32 |
$0.00 |
| 3077F |
|
22 |
12 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
16 |
15 |
$0.00 |