| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,613 |
3,092 |
$250K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,419 |
3,128 |
$174K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,128 |
1,005 |
$113K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
781 |
737 |
$78K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
569 |
522 |
$56K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
402 |
383 |
$44K |
| 99401 |
|
968 |
895 |
$31K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
633 |
613 |
$26K |
| 96127 |
|
1,017 |
968 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
129 |
125 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
184 |
166 |
$3K |
| 96161 |
|
191 |
180 |
$3K |
| 99408 |
|
134 |
130 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$2K |
| 99383 |
|
12 |
12 |
$1K |
| 0071A |
|
27 |
26 |
$875.00 |
| 0072A |
|
13 |
13 |
$420.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$297.70 |
| 90686 |
|
1,514 |
1,404 |
$41.06 |
| 90651 |
|
111 |
100 |
$0.00 |
| 2016F |
|
19 |
17 |
$0.00 |
| 90656 |
|
146 |
141 |
$0.00 |
| 91307 |
|
54 |
52 |
$0.00 |
| 90654 |
|
28 |
25 |
$0.00 |
| 90620 |
|
14 |
14 |
$0.00 |
| 90633 |
|
24 |
24 |
$0.00 |
| 90670 |
|
51 |
42 |
$0.00 |
| 90685 |
|
61 |
51 |
$0.00 |
| 90734 |
|
44 |
42 |
$0.00 |
| 90671 |
|
28 |
28 |
$0.00 |
| 90648 |
|
20 |
14 |
$0.00 |
| 90672 |
|
14 |
14 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |