| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,455 |
4,698 |
$405K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
407 |
367 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
348 |
279 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
243 |
238 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
192 |
177 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,855 |
1,541 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
68 |
67 |
$340.29 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
44 |
$190.12 |
| 87070 |
|
151 |
144 |
$102.26 |
| 90686 |
|
181 |
160 |
$61.98 |
| 96127 |
|
13 |
13 |
$19.24 |
| 92551 |
|
681 |
654 |
$7.61 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
66 |
66 |
$0.00 |
| 99173 |
|
650 |
627 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |