| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,629 |
2,299 |
$223K |
| 99199 |
Unlisted special service, procedure or report |
40,471 |
31,021 |
$184K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,656 |
2,304 |
$171K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,483 |
3,024 |
$153K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
441 |
410 |
$47K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
465 |
372 |
$43K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
914 |
837 |
$9K |
| 96127 |
|
1,348 |
1,167 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
26 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
30 |
$3K |
| D0145 |
Oral evaluation for a patient under three years of age |
68 |
63 |
$3K |
| 90480 |
|
73 |
69 |
$2K |
| 0001A |
|
39 |
32 |
$2K |
| 99205 |
Prolong outpt/office vis |
13 |
12 |
$2K |
| 92551 |
|
940 |
838 |
$2K |
| 99173 |
|
1,055 |
942 |
$2K |
| 0002A |
|
37 |
32 |
$2K |
| D1206 |
Topical application of fluoride varnish |
68 |
63 |
$1K |
| 0072A |
|
24 |
12 |
$1K |
| 90686 |
|
1,011 |
888 |
$933.06 |
| 0012A |
|
16 |
16 |
$910.00 |
| 0011A |
|
15 |
14 |
$780.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
32 |
31 |
$668.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$183.83 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
49 |
43 |
$153.57 |
| 96161 |
|
31 |
27 |
$115.94 |
| 90656 |
|
281 |
273 |
$60.57 |
| 96160 |
|
15 |
15 |
$56.10 |
| 82962 |
|
28 |
25 |
$52.20 |
| 91321 |
|
24 |
24 |
$0.00 |
| 91300 |
|
138 |
111 |
$0.00 |
| 90670 |
|
85 |
73 |
$0.00 |
| G9920 |
Screening performed and negative |
30 |
29 |
$0.00 |
| 90647 |
|
66 |
60 |
$0.00 |
| 91301 |
|
55 |
53 |
$0.00 |
| 90723 |
|
61 |
55 |
$0.00 |
| 90677 |
|
41 |
41 |
$0.00 |
| 90680 |
|
28 |
24 |
$0.00 |