| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,509 |
3,982 |
$251K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,407 |
1,297 |
$113K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,105 |
964 |
$82K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
812 |
811 |
$66K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
584 |
583 |
$46K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
419 |
419 |
$36K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,963 |
2,951 |
$22K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,573 |
1,572 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
882 |
851 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
135 |
128 |
$4K |
| 97802 |
|
448 |
447 |
$2K |
| 96150 |
|
180 |
180 |
$2K |
| 96127 |
|
421 |
421 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
554 |
440 |
$1K |
| 87430 |
|
217 |
209 |
$1K |
| 99460 |
|
12 |
12 |
$609.39 |
| 83655 |
|
42 |
42 |
$579.50 |
| 81002 |
|
267 |
262 |
$496.88 |
| 99442 |
|
12 |
12 |
$432.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
95 |
95 |
$397.89 |
| 92015 |
Determination of refractive state |
98 |
98 |
$323.05 |
| 99441 |
|
14 |
14 |
$311.74 |
| 85018 |
|
56 |
56 |
$105.61 |
| 90670 |
|
546 |
546 |
$0.00 |
| 90734 |
|
106 |
106 |
$0.00 |
| 90715 |
|
43 |
43 |
$0.00 |
| 90633 |
|
369 |
369 |
$0.00 |
| 90698 |
|
581 |
581 |
$0.00 |
| 90744 |
|
112 |
112 |
$0.00 |
| 90686 |
|
248 |
248 |
$0.00 |
| 90680 |
|
205 |
205 |
$0.00 |
| 90651 |
|
68 |
68 |
$0.00 |