| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
946 |
776 |
$50K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
198 |
183 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
92 |
84 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
94 |
89 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
753 |
370 |
$5K |
| 99188 |
|
236 |
217 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
15 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
798 |
411 |
$1K |
| 99177 |
|
49 |
41 |
$660.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
80 |
59 |
$650.66 |
| 90700 |
|
79 |
79 |
$550.00 |
| 90713 |
|
57 |
57 |
$340.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
24 |
24 |
$304.06 |
| 90648 |
|
45 |
45 |
$250.00 |
| 90670 |
|
42 |
42 |
$230.00 |
| 90461 |
|
274 |
169 |
$218.98 |
| 90686 |
|
84 |
82 |
$0.00 |
| S8301 |
Infection control supplies, not otherwise specified |
76 |
64 |
$0.00 |
| 99000 |
|
270 |
239 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 91307 |
|
17 |
13 |
$0.00 |
| 99072 |
|
1,243 |
938 |
$0.00 |