| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,002 |
9,422 |
$677K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,606 |
3,553 |
$117K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,432 |
1,392 |
$91K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
877 |
877 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
534 |
534 |
$34K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,460 |
4,085 |
$27K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,667 |
891 |
$24K |
| 87070 |
|
2,960 |
2,798 |
$18K |
| 87184 |
|
2,961 |
2,799 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
101 |
101 |
$6K |
| 99050 |
|
932 |
900 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
24 |
24 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
14 |
$2K |
| 99381 |
|
14 |
14 |
$868.11 |
| 87807 |
|
14 |
14 |
$174.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$149.76 |
| 99000 |
|
515 |
468 |
$52.59 |
| 90686 |
|
76 |
76 |
$38.61 |
| 36416 |
|
41 |
39 |
$12.76 |