| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,004 |
1,771 |
$112K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,268 |
1,131 |
$104K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
385 |
349 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
266 |
264 |
$23K |
| 99174 |
|
639 |
627 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
102 |
102 |
$9K |
| 85018 |
|
762 |
748 |
$2K |
| 36416 |
|
749 |
736 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
91 |
85 |
$1K |
| 90688 |
|
76 |
76 |
$890.33 |
| 90670 |
|
137 |
137 |
$804.60 |
| 90680 |
|
55 |
55 |
$325.26 |
| 90686 |
|
50 |
46 |
$274.16 |
| 90685 |
|
14 |
14 |
$217.47 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
29 |
$167.70 |
| 95012 |
|
14 |
12 |
$153.66 |
| 90687 |
|
14 |
14 |
$83.44 |
| 81002 |
|
30 |
28 |
$82.48 |
| 90633 |
|
13 |
13 |
$77.48 |
| 90698 |
|
12 |
12 |
$71.52 |
| 90648 |
|
12 |
12 |
$71.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
850 |
824 |
$35.42 |
| 90461 |
|
439 |
429 |
$0.00 |