| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
42,040 |
21,377 |
$315K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,311 |
1,867 |
$179K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,100 |
1,746 |
$115K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,160 |
970 |
$94K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
891 |
764 |
$70K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,572 |
1,331 |
$54K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,682 |
2,290 |
$50K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
282 |
243 |
$24K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,535 |
2,028 |
$21K |
| D0145 |
Oral evaluation for a patient under three years of age |
509 |
435 |
$13K |
| D1206 |
Topical application of fluoride varnish |
489 |
411 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
252 |
201 |
$5K |
| 90474 |
|
162 |
142 |
$3K |
| 96127 |
|
770 |
570 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
26 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
59 |
54 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
97 |
87 |
$1K |
| 87807 |
|
73 |
66 |
$935.42 |
| 96161 |
|
176 |
154 |
$604.08 |
| 99408 |
|
12 |
12 |
$378.72 |
| 83655 |
|
59 |
50 |
$360.64 |
| 90686 |
|
684 |
600 |
$332.13 |
| 90698 |
|
669 |
581 |
$329.16 |
| 85018 |
|
361 |
297 |
$308.87 |
| 92552 |
|
1,050 |
915 |
$185.46 |
| 83718 |
|
13 |
12 |
$127.32 |
| 82465 |
|
13 |
12 |
$67.56 |
| 99173 |
|
1,259 |
1,095 |
$65.64 |
| 90744 |
|
152 |
128 |
$63.25 |
| 90633 |
|
178 |
149 |
$32.22 |
| 94760 |
|
14 |
12 |
$2.07 |
| 90670 |
|
740 |
619 |
$0.00 |
| 90685 |
|
86 |
73 |
$0.00 |
| 90710 |
|
51 |
32 |
$0.00 |
| 90680 |
|
170 |
149 |
$0.00 |
| 90677 |
|
29 |
28 |
$0.00 |