| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,682 |
3,274 |
$213K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,240 |
1,168 |
$112K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,938 |
1,905 |
$40K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
532 |
528 |
$37K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
305 |
305 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
251 |
248 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
531 |
516 |
$7K |
| 81002 |
|
1,661 |
1,634 |
$4K |
| 99174 |
|
1,427 |
1,426 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
22 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
73 |
49 |
$963.87 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
110 |
110 |
$905.68 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
89 |
89 |
$880.31 |
| 81025 |
|
137 |
129 |
$793.07 |
| 99000 |
|
206 |
201 |
$717.52 |
| 85018 |
|
97 |
97 |
$207.45 |
| 85014 |
|
84 |
84 |
$181.97 |
| 98966 |
|
14 |
14 |
$112.70 |
| 99188 |
|
14 |
14 |
$97.02 |
| 96127 |
|
25 |
25 |
$85.68 |
| 99177 |
|
15 |
15 |
$42.64 |
| 90686 |
|
398 |
396 |
$21.57 |
| G9007 |
Coordinated care fee, scheduled team conference |
615 |
363 |
$0.54 |
| G9002 |
Coordinated care fee, maintenance rate |
67 |
44 |
$0.30 |
| 90680 |
|
38 |
38 |
$0.00 |
| 90698 |
|
109 |
109 |
$0.00 |
| 99072 |
|
346 |
308 |
$0.00 |
| 90461 |
|
715 |
714 |
$0.00 |
| 90670 |
|
135 |
135 |
$0.00 |
| 90685 |
|
18 |
18 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |