| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,332 |
10,852 |
$817K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,576 |
1,433 |
$130K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,123 |
1,112 |
$107K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,456 |
3,386 |
$96K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,072 |
1,066 |
$94K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
956 |
952 |
$85K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
604 |
596 |
$51K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,804 |
4,730 |
$48K |
| 87428 |
|
591 |
571 |
$37K |
| 99173 |
|
1,627 |
1,618 |
$36K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
951 |
892 |
$27K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,893 |
1,772 |
$22K |
| 96127 |
|
1,207 |
1,193 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
56 |
56 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
428 |
222 |
$5K |
| 90461 |
|
726 |
724 |
$5K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
61 |
61 |
$4K |
| 94760 |
|
1,609 |
1,368 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
230 |
221 |
$2K |
| 81003 |
|
987 |
954 |
$2K |
| 87807 |
|
131 |
120 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 99051 |
|
35 |
34 |
$579.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$488.40 |
| 90473 |
|
14 |
14 |
$143.15 |
| 90671 |
|
24 |
24 |
$0.00 |
| 90633 |
|
24 |
24 |
$0.00 |
| 90734 |
|
13 |
12 |
$0.00 |
| 90686 |
|
931 |
921 |
$0.00 |
| 90677 |
|
85 |
84 |
$0.00 |
| 90651 |
|
50 |
50 |
$0.00 |