| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,928 |
3,081 |
$268K |
| 99199 |
Unlisted special service, procedure or report |
50,467 |
37,981 |
$231K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,316 |
1,943 |
$136K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,933 |
2,458 |
$112K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
220 |
201 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
178 |
162 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
516 |
414 |
$8K |
| 96127 |
|
1,138 |
1,082 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
16 |
$3K |
| 0012A |
|
44 |
43 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
268 |
249 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
68 |
61 |
$2K |
| 0001A |
|
44 |
44 |
$2K |
| 0011A |
|
44 |
43 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
14 |
$2K |
| 0002A |
|
43 |
38 |
$1K |
| 90686 |
|
1,075 |
876 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19 |
13 |
$663.85 |
| 90674 |
|
208 |
174 |
$570.16 |
| 90656 |
|
203 |
198 |
$241.90 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$226.08 |
| 96161 |
|
37 |
36 |
$131.18 |
| 99173 |
|
227 |
190 |
$128.87 |
| 91300 |
|
136 |
115 |
$11.55 |
| 92552 |
|
26 |
26 |
$1.00 |
| 90647 |
|
14 |
14 |
$0.00 |
| 91301 |
|
109 |
104 |
$0.00 |
| 90677 |
|
20 |
20 |
$0.00 |
| 90723 |
|
17 |
17 |
$0.00 |
| 90680 |
|
17 |
17 |
$0.00 |