| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
979 |
882 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
149 |
144 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
137 |
130 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
46 |
44 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
40 |
35 |
$3K |
| 96127 |
|
155 |
147 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
77 |
69 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90686 |
|
114 |
111 |
$793.89 |
| 90670 |
|
53 |
49 |
$541.73 |
| 92551 |
|
33 |
29 |
$501.60 |
| 99051 |
|
160 |
131 |
$275.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$241.15 |
| 90648 |
|
25 |
25 |
$160.00 |
| 90680 |
|
12 |
12 |
$76.80 |
| 90723 |
|
12 |
12 |
$76.80 |
| 94760 |
|
247 |
202 |
$26.40 |
| 99000 |
|
81 |
76 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
490 |
402 |
$0.00 |
| 1003F |
|
46 |
44 |
$0.00 |
| 90461 |
|
156 |
140 |
$0.00 |
| 99177 |
|
33 |
28 |
$0.00 |