| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,584 |
4,961 |
$219K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,920 |
2,634 |
$159K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,434 |
1,407 |
$128K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,402 |
1,387 |
$119K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
832 |
802 |
$66K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,798 |
2,617 |
$62K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,520 |
1,078 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
640 |
610 |
$9K |
| 90461 |
|
1,649 |
1,338 |
$8K |
| 92567 |
|
474 |
467 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
369 |
327 |
$4K |
| 99429 |
|
104 |
100 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
18 |
$456.16 |
| 0071A |
|
24 |
24 |
$360.00 |
| 0072A |
|
17 |
17 |
$255.00 |
| 90686 |
|
1,409 |
1,379 |
$0.14 |
| 90670 |
|
781 |
755 |
$0.01 |
| 90633 |
|
472 |
464 |
$0.01 |
| 90651 |
|
56 |
55 |
$0.01 |
| 90648 |
|
381 |
377 |
$0.00 |
| 90681 |
|
14 |
13 |
$0.00 |
| 90707 |
|
42 |
41 |
$0.00 |
| 90710 |
|
54 |
54 |
$0.00 |
| 90700 |
|
50 |
49 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 90734 |
|
29 |
28 |
$0.00 |
| 90696 |
|
55 |
55 |
$0.00 |
| 90716 |
|
42 |
41 |
$0.00 |
| 90744 |
|
31 |
27 |
$0.00 |
| 90698 |
|
64 |
59 |
$0.00 |
| 91307 |
|
55 |
47 |
$0.00 |
| 90723 |
|
68 |
68 |
$0.00 |