| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
61 |
58 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48 |
44 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
107 |
96 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
23 |
23 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
23 |
23 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
39 |
37 |
$1K |
| D0145 |
Oral evaluation for a patient under three years of age |
24 |
23 |
$794.65 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
17 |
$500.10 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
45 |
44 |
$407.52 |
| D1206 |
Topical application of fluoride varnish |
24 |
23 |
$350.75 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$310.86 |
| 96127 |
|
28 |
27 |
$119.00 |
| 96161 |
|
17 |
17 |
$63.58 |
| 85018 |
|
13 |
13 |
$35.04 |
| 92552 |
|
41 |
39 |
$5.00 |
| 99173 |
|
44 |
43 |
$2.00 |
| 36416 |
|
17 |
16 |
$0.00 |
| 90698 |
|
16 |
16 |
$0.00 |
| 90686 |
|
31 |
29 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90670 |
|
17 |
17 |
$0.00 |