| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,784 |
17,016 |
$592K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,910 |
1,905 |
$140K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,762 |
1,754 |
$102K |
| G9920 |
Screening performed and negative |
3,669 |
3,606 |
$93K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,663 |
1,586 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
652 |
650 |
$36K |
| 99215 |
Prolong outpt/office vis |
447 |
420 |
$24K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
962 |
896 |
$20K |
| 92551 |
|
4,649 |
4,631 |
$19K |
| 99173 |
|
4,449 |
4,432 |
$15K |
| 90686 |
|
3,025 |
3,011 |
$14K |
| 96127 |
|
4,611 |
2,666 |
$10K |
| 3044F |
|
1,183 |
1,178 |
$7K |
| 99384 |
|
71 |
71 |
$6K |
| 99383 |
|
65 |
65 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
449 |
221 |
$5K |
| 87430 |
|
411 |
402 |
$4K |
| 90620 |
|
548 |
542 |
$4K |
| 90674 |
|
420 |
417 |
$3K |
| 90651 |
|
337 |
333 |
$1K |
| 90658 |
|
171 |
167 |
$1K |
| 99382 |
|
12 |
12 |
$1K |
| 90734 |
|
239 |
238 |
$895.75 |
| 90661 |
|
53 |
53 |
$387.00 |
| 86403 |
|
47 |
44 |
$370.24 |
| 90619 |
|
54 |
54 |
$333.00 |
| 90670 |
|
29 |
28 |
$261.69 |
| 90649 |
|
20 |
20 |
$159.00 |
| 90700 |
|
51 |
51 |
$108.00 |
| 90713 |
|
12 |
12 |
$108.00 |
| 86580 |
|
457 |
454 |
$75.90 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
338 |
337 |
$22.00 |
| 3078F |
|
12 |
12 |
$0.00 |
| 90715 |
|
25 |
24 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |