| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,379 |
3,048 |
$65K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
650 |
644 |
$25K |
| 92081 |
|
1,401 |
1,384 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
436 |
435 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
500 |
489 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,308 |
812 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
365 |
350 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
653 |
615 |
$8K |
| 92552 |
|
1,408 |
1,392 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
109 |
108 |
$3K |
| 85018 |
|
2,349 |
2,308 |
$3K |
| 81002 |
|
1,543 |
1,510 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
329 |
317 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
29 |
$910.45 |
| 96156 |
|
14 |
14 |
$773.55 |
| 97802 |
|
25 |
25 |
$599.28 |
| 90670 |
|
190 |
186 |
$549.00 |
| 99381 |
|
12 |
12 |
$538.56 |
| 90698 |
|
192 |
187 |
$342.00 |
| 90686 |
|
723 |
677 |
$280.47 |
| 90680 |
|
42 |
42 |
$190.00 |
| 90744 |
|
59 |
59 |
$180.00 |
| 86580 |
|
100 |
99 |
$169.37 |
| 90620 |
|
117 |
114 |
$127.13 |
| 90633 |
|
143 |
139 |
$63.00 |
| 90651 |
|
205 |
205 |
$40.00 |
| 90685 |
|
110 |
92 |
$10.00 |
| 90734 |
|
175 |
175 |
$9.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
19 |
19 |
$0.00 |
| 90715 |
|
95 |
95 |
$0.00 |