| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,393 |
5,782 |
$432K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,878 |
2,752 |
$267K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,155 |
2,154 |
$174K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,308 |
2,289 |
$166K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,623 |
5,556 |
$122K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,506 |
1,505 |
$113K |
| 92552 |
|
2,882 |
2,880 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
449 |
449 |
$38K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,340 |
1,279 |
$18K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
238 |
237 |
$7K |
| 99174 |
|
2,533 |
2,530 |
$5K |
| 99460 |
|
83 |
83 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
101 |
100 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
69 |
69 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
60 |
49 |
$989.40 |
| 0071A |
|
18 |
18 |
$630.00 |
| 0072A |
|
16 |
16 |
$560.00 |
| 81002 |
|
105 |
102 |
$268.92 |
| 90671 |
|
197 |
197 |
$246.20 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$121.44 |
| 97803 |
|
475 |
475 |
$90.00 |
| 90686 |
|
275 |
275 |
$42.05 |
| 90680 |
|
1,188 |
1,184 |
$0.00 |
| 94760 |
|
1,930 |
1,792 |
$0.00 |
| 90716 |
|
321 |
320 |
$0.00 |
| 90697 |
|
199 |
198 |
$0.00 |
| 90698 |
|
1,405 |
1,403 |
$0.00 |
| 3008F |
|
809 |
809 |
$0.00 |
| 90744 |
|
608 |
607 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 90656 |
|
50 |
50 |
$0.00 |
| 90651 |
|
29 |
29 |
$0.00 |
| 90633 |
|
430 |
430 |
$0.00 |
| 90670 |
|
1,558 |
1,555 |
$0.00 |
| 90707 |
|
302 |
301 |
$0.00 |
| 99072 |
|
13 |
13 |
$0.00 |
| 90685 |
|
36 |
36 |
$0.00 |