| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,669 |
4,499 |
$210K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,792 |
4,754 |
$110K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
563 |
562 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
561 |
561 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
262 |
254 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
68 |
68 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$2K |
| 90656 |
|
96 |
96 |
$1K |
| 0071A |
|
24 |
24 |
$934.65 |
| H0049 |
Alcohol and/or drug screening |
70 |
70 |
$914.88 |
| G9920 |
Screening performed and negative |
28 |
28 |
$736.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
65 |
64 |
$613.45 |
| 0072A |
|
12 |
12 |
$464.79 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
38 |
38 |
$130.39 |
| 94760 |
|
362 |
336 |
$89.30 |
| 90686 |
|
1,208 |
1,205 |
$76.12 |
| 99499 |
|
41 |
41 |
$0.00 |
| 99080 |
|
52 |
52 |
$0.00 |
| 91307 |
|
39 |
39 |
$0.00 |