| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,545 |
7,244 |
$532K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,483 |
2,674 |
$272K |
| 99199 |
Unlisted special service, procedure or report |
39,592 |
24,081 |
$235K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,790 |
2,050 |
$220K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,595 |
1,910 |
$191K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,592 |
6,372 |
$134K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,034 |
3,060 |
$106K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,069 |
787 |
$83K |
| 99401 |
|
2,989 |
1,853 |
$73K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,800 |
1,392 |
$49K |
| D1206 |
Topical application of fluoride varnish |
1,793 |
1,389 |
$23K |
| 90474 |
|
773 |
614 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,141 |
449 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,331 |
1,074 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
102 |
80 |
$10K |
| 83655 |
|
736 |
537 |
$8K |
| 92551 |
|
3,630 |
2,608 |
$7K |
| 99381 |
|
36 |
30 |
$3K |
| 85018 |
|
2,483 |
1,769 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
89 |
62 |
$3K |
| 99173 |
|
3,618 |
2,770 |
$2K |
| 96161 |
|
635 |
416 |
$2K |
| 0072A |
|
28 |
24 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
108 |
88 |
$1K |
| 99177 |
|
4,426 |
3,525 |
$1K |
| 90686 |
|
2,534 |
1,934 |
$920.58 |
| 96127 |
|
245 |
184 |
$901.59 |
| 81003 |
|
482 |
319 |
$324.09 |
| 87807 |
|
23 |
15 |
$211.95 |
| 83718 |
|
19 |
12 |
$121.20 |
| 90633 |
|
497 |
367 |
$102.00 |
| 82465 |
|
19 |
12 |
$64.32 |
| 36416 |
|
2,131 |
1,585 |
$3.16 |
| 94760 |
|
156 |
138 |
$2.07 |
| 90670 |
|
1,553 |
1,177 |
$0.00 |
| 90648 |
|
1,530 |
1,160 |
$0.00 |
| 90700 |
|
71 |
49 |
$0.00 |
| 91308 |
|
42 |
26 |
$0.00 |
| 90685 |
|
201 |
162 |
$0.00 |
| 90707 |
|
32 |
28 |
$0.00 |
| 90680 |
|
818 |
645 |
$0.00 |
| 90723 |
|
883 |
682 |
$0.00 |
| 91307 |
|
73 |
30 |
$0.00 |
| 90716 |
|
46 |
41 |
$0.00 |