| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,769 |
2,225 |
$163K |
| 92587 |
|
970 |
905 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,094 |
991 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
194 |
193 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
171 |
166 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
162 |
159 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
207 |
193 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
83 |
82 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
51 |
$4K |
| 99443 |
|
69 |
49 |
$3K |
| 99401 |
|
33 |
31 |
$1K |
| 92567 |
|
49 |
38 |
$852.79 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
123 |
119 |
$616.16 |
| 90461 |
|
12 |
12 |
$341.00 |
| 36406 |
|
15 |
14 |
$92.97 |
| 99173 |
|
463 |
448 |
$70.56 |
| 36415 |
Collection of venous blood by venipuncture |
450 |
437 |
$56.92 |
| 90688 |
|
172 |
172 |
$54.45 |
| 90658 |
|
78 |
78 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
49 |
28 |
$0.00 |
| 99000 |
|
54 |
53 |
$0.00 |