| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,530 |
5,256 |
$265K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,582 |
4,477 |
$264K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,589 |
1,531 |
$124K |
| 90461 |
|
379 |
379 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
231 |
228 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
91 |
91 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
330 |
316 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
70 |
69 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
42 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
94 |
94 |
$3K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
25 |
25 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
202 |
198 |
$2K |
| 0072A |
|
16 |
16 |
$889.60 |
| 0071A |
|
16 |
16 |
$800.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
80 |
80 |
$770.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$301.34 |
| 96127 |
|
92 |
92 |
$286.80 |
| 87081 |
|
43 |
43 |
$194.88 |
| 90686 |
|
1,824 |
1,819 |
$102.46 |
| 83655 |
|
12 |
12 |
$101.76 |
| 81000 |
|
15 |
12 |
$42.15 |
| 85018 |
|
12 |
12 |
$19.92 |
| 85014 |
|
12 |
12 |
$19.92 |
| 99174 |
|
27 |
27 |
$7.54 |
| 90656 |
|
146 |
146 |
$0.00 |
| 90647 |
|
25 |
25 |
$0.00 |
| 1036F |
|
12 |
12 |
$0.00 |
| 90671 |
|
28 |
28 |
$0.00 |
| 99072 |
|
120 |
118 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |