| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,698 |
1,546 |
$61K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
244 |
244 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
324 |
309 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,719 |
805 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
173 |
172 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
73 |
73 |
$7K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
34 |
34 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
288 |
225 |
$2K |
| 90461 |
|
276 |
234 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
24 |
$613.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
41 |
$527.82 |
| 99429 |
|
15 |
15 |
$512.40 |
| S8301 |
Infection control supplies, not otherwise specified |
475 |
429 |
$415.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
16 |
16 |
$0.06 |
| 90688 |
|
205 |
202 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
55 |
55 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
15 |
15 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
59 |
58 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |