| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,473 |
1,231 |
$50K |
| 90671 |
|
189 |
157 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,334 |
928 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
355 |
307 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
329 |
298 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
199 |
176 |
$8K |
| 90651 |
|
155 |
128 |
$8K |
| 92551 |
|
718 |
620 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
191 |
163 |
$7K |
| 90461 |
|
408 |
321 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
223 |
196 |
$5K |
| 96127 |
|
1,191 |
1,035 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
30 |
$1K |
| 90734 |
|
49 |
47 |
$1K |
| 90686 |
|
524 |
486 |
$1K |
| 96160 |
|
712 |
614 |
$1K |
| 36416 |
|
102 |
82 |
$720.00 |
| 90620 |
|
13 |
12 |
$671.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
35 |
29 |
$369.60 |
| 90716 |
|
29 |
27 |
$348.64 |
| 90633 |
|
93 |
90 |
$231.42 |
| 90680 |
|
89 |
77 |
$191.92 |
| 90715 |
|
16 |
12 |
$143.49 |
| 90723 |
|
79 |
65 |
$97.97 |
| 90707 |
|
12 |
12 |
$92.49 |
| 90648 |
|
197 |
157 |
$88.52 |
| 86580 |
|
12 |
12 |
$52.80 |
| 97802 |
|
690 |
599 |
$35.10 |
| 99173 |
|
748 |
645 |
$2.34 |
| 99000 |
|
115 |
94 |
$0.00 |
| 94761 |
|
700 |
610 |
$0.00 |
| 96161 |
|
16 |
16 |
$0.00 |