| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,535 |
5,863 |
$236K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,370 |
1,274 |
$76K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
657 |
617 |
$51K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
486 |
482 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,073 |
2,008 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
356 |
348 |
$32K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
446 |
416 |
$2K |
| H0049 |
Alcohol and/or drug screening |
270 |
266 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
61 |
61 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
13 |
$899.11 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
90 |
90 |
$518.83 |
| 0011A |
|
15 |
13 |
$320.00 |
| 94010 |
|
12 |
12 |
$190.62 |
| 90686 |
|
124 |
121 |
$10.00 |
| 81002 |
|
141 |
141 |
$0.00 |
| 96160 |
|
103 |
103 |
$0.00 |