| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,129 |
1,928 |
$128K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,146 |
1,042 |
$98K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
748 |
680 |
$61K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
578 |
569 |
$53K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
229 |
226 |
$21K |
| 90686 |
|
394 |
391 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
27 |
$3K |
| 90670 |
|
212 |
206 |
$3K |
| 90655 |
|
158 |
155 |
$2K |
| 90648 |
|
91 |
90 |
$1K |
| 96127 |
|
320 |
300 |
$972.70 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
14 |
$553.14 |
| 90633 |
|
43 |
42 |
$501.18 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
52 |
$258.89 |
| 90680 |
|
26 |
25 |
$193.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$171.27 |
| 90723 |
|
12 |
12 |
$93.60 |
| 94760 |
|
334 |
292 |
$67.59 |
| 99174 |
|
13 |
13 |
$41.76 |
| T1015 |
Clinic visit/encounter, all-inclusive |
260 |
242 |
$0.00 |