| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,060 |
1,670 |
$80K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
677 |
595 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
638 |
576 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
457 |
383 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
675 |
593 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
549 |
450 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
187 |
160 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
64 |
54 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
460 |
190 |
$4K |
| 92552 |
|
289 |
242 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
391 |
323 |
$3K |
| 92015 |
Determination of refractive state |
90 |
62 |
$2K |
| 92587 |
|
91 |
70 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
110 |
102 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
196 |
176 |
$2K |
| 96127 |
|
540 |
445 |
$2K |
| 96160 |
|
365 |
273 |
$2K |
| 99173 |
|
223 |
198 |
$754.32 |
| 83655 |
|
74 |
69 |
$615.36 |
| 87807 |
|
70 |
55 |
$578.67 |
| 85018 |
|
249 |
198 |
$448.25 |
| 3008F |
|
84 |
77 |
$358.00 |
| 92551 |
|
50 |
50 |
$335.62 |
| 99177 |
|
59 |
54 |
$275.90 |
| 81003 |
|
139 |
114 |
$173.10 |
| 36416 |
|
119 |
88 |
$104.41 |
| 99174 |
|
13 |
12 |
$42.04 |
| 90680 |
|
101 |
95 |
$0.00 |
| 90686 |
|
123 |
113 |
$0.00 |
| 90723 |
|
168 |
154 |
$0.00 |
| 90716 |
|
48 |
40 |
$0.00 |
| 90651 |
|
14 |
13 |
$0.00 |
| 90670 |
|
280 |
248 |
$0.00 |
| 90648 |
|
275 |
244 |
$0.00 |
| 90633 |
|
58 |
58 |
$0.00 |
| 90685 |
|
61 |
59 |
$0.00 |
| 90707 |
|
49 |
41 |
$0.00 |