| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,456 |
8,882 |
$653K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,262 |
5,381 |
$559K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
10,271 |
8,597 |
$410K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,904 |
3,024 |
$326K |
| 99199 |
Unlisted special service, procedure or report |
69,253 |
51,544 |
$293K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,862 |
2,604 |
$284K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
6,104 |
5,329 |
$56K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
470 |
386 |
$41K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
422 |
382 |
$38K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
761 |
647 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,310 |
1,125 |
$23K |
| 96127 |
|
3,509 |
2,985 |
$15K |
| 99051 |
|
539 |
495 |
$12K |
| 92551 |
|
4,039 |
3,573 |
$6K |
| 96161 |
|
1,690 |
1,267 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
202 |
184 |
$5K |
| 90686 |
|
4,342 |
3,690 |
$4K |
| D0145 |
Oral evaluation for a patient under three years of age |
113 |
97 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
252 |
223 |
$3K |
| 99173 |
|
3,543 |
3,128 |
$3K |
| 0071A |
|
63 |
38 |
$2K |
| 90670 |
|
2,162 |
1,637 |
$2K |
| D1206 |
Topical application of fluoride varnish |
94 |
86 |
$1K |
| 90480 |
|
35 |
30 |
$1K |
| 90474 |
|
79 |
52 |
$1K |
| 0072A |
|
28 |
20 |
$1K |
| 90674 |
|
832 |
716 |
$1K |
| 90698 |
|
2,452 |
1,923 |
$875.54 |
| 90651 |
|
40 |
37 |
$726.20 |
| 90734 |
|
40 |
28 |
$652.13 |
| 90680 |
|
916 |
635 |
$190.42 |
| 85018 |
|
65 |
54 |
$169.08 |
| 90633 |
|
294 |
249 |
$167.60 |
| 90656 |
|
379 |
369 |
$136.85 |
| 99177 |
|
254 |
213 |
$122.99 |
| 90744 |
|
326 |
223 |
$80.15 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$34.08 |
| G9920 |
Screening performed and negative |
359 |
356 |
$0.00 |
| 91311 |
|
35 |
30 |
$0.00 |
| 1003F |
|
239 |
236 |
$0.00 |
| 91321 |
|
18 |
13 |
$0.00 |
| 90677 |
|
125 |
125 |
$0.00 |