| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,488 |
1,278 |
$64K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
513 |
477 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,389 |
724 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
179 |
176 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
162 |
155 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
195 |
181 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
168 |
158 |
$8K |
| 92567 |
|
546 |
523 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
821 |
784 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
464 |
420 |
$6K |
| 99215 |
Prolong outpt/office vis |
55 |
54 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
155 |
132 |
$4K |
| 92552 |
|
300 |
287 |
$3K |
| 92587 |
|
129 |
121 |
$2K |
| 81002 |
|
774 |
715 |
$2K |
| 80061 |
Lipid panel |
135 |
130 |
$2K |
| 85018 |
|
684 |
656 |
$2K |
| 87807 |
|
114 |
106 |
$2K |
| 82962 |
|
587 |
552 |
$1K |
| 90686 |
|
204 |
203 |
$469.05 |
| 90700 |
|
205 |
189 |
$465.45 |
| 90713 |
|
162 |
151 |
$390.90 |
| 90648 |
|
140 |
127 |
$335.45 |
| 90670 |
|
158 |
147 |
$295.45 |
| 36416 |
|
722 |
682 |
$283.73 |
| 90680 |
|
97 |
87 |
$235.45 |
| 81003 |
|
56 |
54 |
$128.79 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$100.08 |
| 96127 |
|
39 |
38 |
$98.30 |
| 90651 |
|
86 |
81 |
$90.00 |
| 90461 |
|
285 |
248 |
$57.50 |
| 90734 |
|
60 |
57 |
$55.45 |
| 99173 |
|
25 |
24 |
$54.48 |
| 90633 |
|
12 |
12 |
$40.00 |
| 90707 |
|
13 |
13 |
$30.00 |
| 90716 |
|
14 |
13 |
$30.00 |
| 90744 |
|
12 |
12 |
$25.45 |
| 90715 |
|
14 |
13 |
$20.00 |
| 90621 |
|
17 |
17 |
$0.00 |