| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,618 |
3,143 |
$202K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,396 |
2,012 |
$183K |
| 99199 |
Unlisted special service, procedure or report |
8,748 |
6,962 |
$54K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,991 |
2,413 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
456 |
397 |
$37K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
785 |
669 |
$29K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,452 |
681 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
224 |
204 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
221 |
185 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,040 |
982 |
$14K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
401 |
283 |
$13K |
| 99215 |
Prolong outpt/office vis |
129 |
97 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
162 |
131 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,552 |
1,246 |
$11K |
| 80061 |
Lipid panel |
443 |
390 |
$6K |
| D0145 |
Oral evaluation for a patient under three years of age |
162 |
130 |
$5K |
| 96127 |
|
934 |
806 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
35 |
31 |
$3K |
| D1206 |
Topical application of fluoride varnish |
162 |
130 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
33 |
27 |
$953.25 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
51 |
27 |
$708.51 |
| 85018 |
|
1,667 |
1,519 |
$525.91 |
| 92552 |
|
138 |
75 |
$506.48 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
13 |
13 |
$263.10 |
| 90474 |
|
14 |
12 |
$257.64 |
| 90651 |
|
14 |
12 |
$220.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
18 |
14 |
$160.24 |
| 81002 |
|
380 |
356 |
$44.06 |
| 96161 |
|
50 |
24 |
$43.40 |
| 96160 |
|
23 |
12 |
$11.79 |
| 99173 |
|
1,288 |
1,132 |
$10.00 |
| 88738 |
|
17 |
16 |
$6.34 |
| 90734 |
|
13 |
13 |
$0.00 |
| 90681 |
|
26 |
12 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
23 |
13 |
$0.00 |
| 90670 |
|
115 |
82 |
$0.00 |
| 92551 |
|
1,166 |
1,071 |
$0.00 |
| 90688 |
|
278 |
266 |
$0.00 |
| 90698 |
|
120 |
87 |
$0.00 |
| 90686 |
|
126 |
75 |
$0.00 |
| 90680 |
|
13 |
12 |
$0.00 |