| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,456 |
1,196 |
$115K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
278 |
263 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
256 |
234 |
$26K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
197 |
178 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
99 |
88 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,419 |
1,248 |
$11K |
| 90686 |
|
401 |
360 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
161 |
149 |
$8K |
| 90677 |
|
39 |
38 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
17 |
$2K |
| 99174 |
|
405 |
380 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
151 |
117 |
$1K |
| 0071A |
|
22 |
20 |
$647.39 |
| 0072A |
|
17 |
17 |
$601.62 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
69 |
29 |
$433.70 |
| 90723 |
|
12 |
12 |
$279.36 |
| 90656 |
|
12 |
12 |
$279.36 |
| 96160 |
|
36 |
33 |
$83.94 |
| 99173 |
|
12 |
12 |
$20.80 |
| 91307 |
|
31 |
29 |
$0.14 |