| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,964 |
3,840 |
$377K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,248 |
4,103 |
$241K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,625 |
2,275 |
$87K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,005 |
1,005 |
$84K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
765 |
765 |
$64K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
656 |
656 |
$60K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
449 |
444 |
$35K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,124 |
2,960 |
$33K |
| 90461 |
|
910 |
910 |
$30K |
| 92588 |
|
676 |
676 |
$29K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,751 |
2,723 |
$20K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,507 |
1,506 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,017 |
1,005 |
$13K |
| 96127 |
|
1,151 |
1,140 |
$12K |
| 99173 |
|
511 |
511 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
583 |
417 |
$7K |
| 83655 |
|
551 |
550 |
$6K |
| 87081 |
|
805 |
799 |
$5K |
| 82465 |
|
1,169 |
1,169 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
126 |
124 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
126 |
124 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
82 |
82 |
$3K |
| 95930 |
|
26 |
26 |
$2K |
| 86003 |
|
17 |
12 |
$2K |
| 96161 |
|
210 |
210 |
$810.60 |
| 81002 |
|
271 |
262 |
$705.99 |
| 92555 |
|
26 |
26 |
$503.62 |
| 99050 |
|
30 |
30 |
$496.80 |
| 87807 |
|
38 |
38 |
$438.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
18 |
$368.10 |
| 99188 |
|
12 |
12 |
$312.00 |
| 87070 |
|
21 |
21 |
$186.48 |