| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,552 |
2,154 |
$92K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
463 |
445 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
432 |
396 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
349 |
340 |
$29K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,585 |
969 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
351 |
326 |
$18K |
| 99215 |
Prolong outpt/office vis |
126 |
118 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,188 |
623 |
$9K |
| 90670 |
|
324 |
309 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
65 |
63 |
$6K |
| 90461 |
|
690 |
557 |
$5K |
| 90716 |
|
135 |
123 |
$3K |
| 90707 |
|
134 |
121 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
23 |
23 |
$1K |
| 90680 |
|
168 |
162 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 90633 |
|
128 |
118 |
$779.69 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
35 |
35 |
$493.05 |
| 90648 |
|
116 |
112 |
$198.96 |
| 90672 |
|
74 |
72 |
$151.92 |
| 96160 |
|
68 |
66 |
$144.68 |
| 90658 |
|
136 |
133 |
$126.02 |
| 90713 |
|
18 |
16 |
$112.89 |
| 90700 |
|
113 |
102 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 90698 |
|
99 |
94 |
$0.00 |
| 90657 |
|
48 |
44 |
$0.00 |