| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,166 |
3,061 |
$245K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,831 |
3,665 |
$189K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,630 |
1,628 |
$149K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,282 |
1,269 |
$114K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
979 |
979 |
$73K |
| 99051 |
|
2,193 |
2,160 |
$61K |
| 99215 |
Prolong outpt/office vis |
278 |
270 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
243 |
243 |
$21K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
752 |
732 |
$11K |
| 90686 |
|
1,005 |
992 |
$3K |
| 90648 |
|
1,064 |
1,050 |
$3K |
| 90670 |
|
756 |
744 |
$3K |
| 99188 |
|
117 |
116 |
$2K |
| 90723 |
|
772 |
763 |
$2K |
| 90680 |
|
647 |
639 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 90633 |
|
274 |
268 |
$638.00 |
| 85018 |
|
752 |
749 |
$406.79 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$384.03 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,423 |
1,420 |
$335.67 |
| 87428 |
|
12 |
12 |
$285.96 |
| 99177 |
|
775 |
774 |
$280.58 |
| 92551 |
|
706 |
706 |
$223.48 |
| 96127 |
|
467 |
467 |
$109.12 |
| 96160 |
|
467 |
467 |
$91.12 |
| 83655 |
|
262 |
262 |
$0.00 |
| G9920 |
Screening performed and negative |
748 |
747 |
$0.00 |
| 90661 |
|
104 |
104 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 80061 |
Lipid panel |
12 |
12 |
$0.00 |
| 96161 |
|
1,113 |
1,101 |
$0.00 |
| 90677 |
|
301 |
300 |
$0.00 |
| 90651 |
|
88 |
88 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
164 |
163 |
$0.00 |
| 90619 |
|
25 |
25 |
$0.00 |
| 90656 |
|
85 |
85 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |