| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,094 |
1,016 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
510 |
489 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,756 |
775 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
388 |
361 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
329 |
322 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
324 |
295 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
140 |
137 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
940 |
757 |
$8K |
| 99188 |
|
203 |
187 |
$5K |
| 96127 |
|
861 |
579 |
$4K |
| 90677 |
|
202 |
183 |
$909.27 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
17 |
$511.73 |
| 96161 |
|
239 |
210 |
$497.40 |
| 87428 |
|
14 |
14 |
$472.03 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
37 |
37 |
$434.70 |
| 90686 |
|
120 |
118 |
$258.17 |
| 90716 |
|
18 |
14 |
$178.91 |
| 36416 |
|
50 |
44 |
$156.07 |
| 90707 |
|
16 |
12 |
$98.44 |
| 92551 |
|
13 |
13 |
$88.15 |
| 85018 |
|
50 |
44 |
$87.81 |
| 90633 |
|
59 |
52 |
$80.69 |
| 90680 |
|
90 |
85 |
$10.50 |
| 3078F |
|
21 |
21 |
$0.00 |
| 90710 |
|
15 |
13 |
$0.00 |
| 90696 |
|
29 |
25 |
$0.00 |
| 90651 |
|
96 |
92 |
$0.00 |
| 90698 |
|
48 |
45 |
$0.00 |
| 90656 |
|
127 |
122 |
$0.00 |
| 90697 |
|
48 |
46 |
$0.00 |
| 3074F |
|
21 |
21 |
$0.00 |
| 90619 |
|
45 |
43 |
$0.00 |