| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,934 |
3,741 |
$264K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,976 |
1,968 |
$107K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
985 |
985 |
$99K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
843 |
841 |
$78K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
660 |
660 |
$59K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
175 |
175 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50 |
49 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
225 |
219 |
$4K |
| 99188 |
|
128 |
128 |
$3K |
| 96161 |
|
382 |
382 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$621.76 |
| 99173 |
|
722 |
722 |
$502.71 |
| 92551 |
|
657 |
657 |
$414.83 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$281.54 |
| 96160 |
|
398 |
398 |
$160.59 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
307 |
307 |
$134.75 |
| 96127 |
|
178 |
178 |
$93.50 |
| 83655 |
|
55 |
55 |
$30.05 |
| 90670 |
|
214 |
166 |
$0.00 |
| 90633 |
|
24 |
12 |
$0.00 |
| 90710 |
|
21 |
12 |
$0.00 |
| 90677 |
|
19 |
19 |
$0.00 |
| 90723 |
|
162 |
122 |
$0.00 |
| 90680 |
|
132 |
96 |
$0.00 |
| 3008F |
|
2,346 |
2,265 |
$0.00 |
| 90647 |
|
141 |
105 |
$0.00 |
| 90686 |
|
131 |
110 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
42 |
42 |
$0.00 |
| 90696 |
|
23 |
13 |
$0.00 |