| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,397 |
3,101 |
$125K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,160 |
1,091 |
$60K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
472 |
472 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
411 |
409 |
$34K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
246 |
89 |
$25K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
409 |
402 |
$15K |
| 92567 |
|
856 |
856 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,215 |
692 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
90 |
90 |
$7K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,067 |
1,945 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
226 |
219 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
669 |
655 |
$4K |
| 94760 |
|
1,496 |
1,494 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
418 |
201 |
$3K |
| 90461 |
|
531 |
154 |
$2K |
| 87420 |
|
200 |
194 |
$1K |
| 86308 |
|
277 |
275 |
$562.18 |
| 99429 |
|
12 |
12 |
$368.28 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
17 |
$138.38 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
68 |
67 |
$111.70 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
14 |
$41.69 |
| 82947 |
|
13 |
13 |
$15.30 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90649 |
|
15 |
15 |
$0.00 |
| 90734 |
|
40 |
40 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 36416 |
|
345 |
324 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,771 |
1,678 |
$0.00 |
| 90686 |
|
223 |
221 |
$0.00 |