| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,139 |
2,062 |
$144K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,171 |
1,169 |
$53K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
282 |
282 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
198 |
196 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
148 |
148 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
52 |
51 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
50 |
50 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
97 |
97 |
$2K |
| 99188 |
|
12 |
12 |
$288.00 |
| 96380 |
|
12 |
12 |
$264.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
105 |
105 |
$115.50 |
| 96161 |
|
39 |
39 |
$114.96 |
| 92551 |
|
122 |
122 |
$112.44 |
| 96127 |
|
52 |
52 |
$55.00 |
| 96160 |
|
74 |
74 |
$47.90 |
| 83655 |
|
43 |
43 |
$34.45 |
| 3008F |
|
1,480 |
1,423 |
$0.00 |
| 90686 |
|
135 |
104 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
25 |
25 |
$0.00 |
| 99173 |
|
156 |
156 |
$0.00 |