| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,133 |
948 |
$45K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,278 |
948 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
464 |
398 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,016 |
645 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
346 |
261 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
316 |
240 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
169 |
143 |
$11K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
726 |
563 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
253 |
221 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
147 |
117 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
287 |
148 |
$3K |
| 80061 |
Lipid panel |
261 |
189 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
222 |
211 |
$2K |
| 92551 |
|
337 |
264 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
94 |
64 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
16 |
$2K |
| 36416 |
|
813 |
637 |
$1K |
| 99173 |
|
270 |
200 |
$1K |
| 99382 |
|
35 |
22 |
$1K |
| 96161 |
|
82 |
66 |
$1K |
| 82947 |
|
232 |
176 |
$864.87 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$654.19 |
| 96127 |
|
133 |
101 |
$561.64 |
| 90461 |
|
422 |
295 |
$327.02 |
| 83655 |
|
17 |
13 |
$200.01 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22 |
16 |
$123.00 |
| 87807 |
|
13 |
12 |
$118.06 |
| 90686 |
|
314 |
278 |
$62.42 |
| 90670 |
|
176 |
136 |
$0.00 |
| 99000 |
|
229 |
196 |
$0.00 |
| 90647 |
|
48 |
38 |
$0.00 |
| 90723 |
|
35 |
25 |
$0.00 |