| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,928 |
17,750 |
$941K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,982 |
7,850 |
$241K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,252 |
498 |
$156K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
11,066 |
11,025 |
$140K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,203 |
2,098 |
$113K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,348 |
1,330 |
$90K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,306 |
1,305 |
$76K |
| 87430 |
|
3,399 |
3,336 |
$46K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
740 |
740 |
$44K |
| 90461 |
|
1,302 |
1,232 |
$35K |
| 90834 |
Psychotherapy, 45 minutes with patient |
221 |
98 |
$19K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,385 |
687 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
220 |
220 |
$10K |
| G0008 |
Administration of influenza virus vaccine |
542 |
541 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
145 |
138 |
$7K |
| 87081 |
|
925 |
909 |
$6K |
| 96127 |
|
446 |
442 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
126 |
126 |
$2K |
| 83655 |
|
80 |
80 |
$990.11 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
86 |
86 |
$778.30 |
| 92587 |
|
39 |
39 |
$687.03 |
| 92015 |
Determination of refractive state |
28 |
28 |
$360.64 |
| 99173 |
|
12 |
12 |
$286.02 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12 |
12 |
$104.04 |
| 90686 |
|
2,318 |
2,314 |
$89.41 |
| 96160 |
|
18 |
18 |
$2.14 |
| 90656 |
|
362 |
362 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
313 |
311 |
$0.00 |
| 90723 |
|
37 |
37 |
$0.00 |
| 90697 |
|
91 |
91 |
$0.00 |
| 90677 |
|
117 |
117 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
86 |
86 |
$0.00 |
| 90685 |
|
146 |
146 |
$0.00 |
| 90670 |
|
264 |
264 |
$0.00 |
| 90648 |
|
202 |
202 |
$0.00 |
| 90633 |
|
28 |
28 |
$0.00 |
| 90687 |
|
31 |
31 |
$0.00 |