| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,243 |
5,121 |
$555K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
910 |
852 |
$124K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
855 |
855 |
$97K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
808 |
752 |
$85K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,870 |
2,823 |
$64K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
340 |
340 |
$38K |
| 92552 |
|
837 |
836 |
$32K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,725 |
2,299 |
$27K |
| 92587 |
|
530 |
529 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
142 |
142 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
152 |
142 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
850 |
427 |
$9K |
| 99050 |
|
956 |
858 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
65 |
65 |
$8K |
| 87070 |
|
1,172 |
1,102 |
$7K |
| 87184 |
|
1,349 |
1,260 |
$7K |
| 86317 |
|
1,353 |
1,261 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
663 |
610 |
$4K |
| 90677 |
|
12 |
12 |
$2K |
| 81000 |
|
658 |
614 |
$2K |
| 36410 |
|
37 |
37 |
$610.40 |
| 36415 |
Collection of venous blood by venipuncture |
232 |
231 |
$323.05 |
| 90686 |
|
386 |
377 |
$238.35 |
| 36406 |
|
12 |
12 |
$192.64 |
| 99174 |
|
305 |
305 |
$106.51 |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
28 |
28 |
$27.51 |
| 99000 |
|
1,467 |
1,372 |
$17.82 |
| A6411 |
Eye pad, non-sterile, each |
28 |
28 |
$0.30 |
| 90461 |
|
100 |
100 |
$0.00 |
| A4558 |
Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz |
28 |
28 |
$0.00 |
| 99072 |
|
233 |
198 |
$0.00 |