| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,594 |
3,212 |
$339K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,266 |
2,907 |
$225K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,462 |
1,408 |
$181K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,125 |
1,090 |
$135K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,084 |
979 |
$124K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
401 |
377 |
$48K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,363 |
2,244 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
222 |
152 |
$7K |
| 92587 |
|
1,197 |
1,138 |
$3K |
| 90461 |
|
856 |
826 |
$3K |
| 90670 |
|
227 |
224 |
$999.83 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
251 |
242 |
$751.11 |
| 90716 |
|
58 |
42 |
$561.98 |
| 81000 |
|
384 |
359 |
$262.97 |
| 90698 |
|
186 |
180 |
$227.04 |
| 90686 |
|
37 |
37 |
$118.02 |
| 90707 |
|
43 |
36 |
$106.02 |
| 97802 |
|
890 |
820 |
$101.72 |
| 90715 |
|
13 |
13 |
$15.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,170 |
1,092 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
52 |
47 |
$0.00 |
| 99173 |
|
561 |
530 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |