| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,899 |
4,196 |
$257K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,954 |
1,867 |
$47K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
454 |
433 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
169 |
168 |
$10K |
| 99401 |
|
229 |
208 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
116 |
116 |
$7K |
| 90651 |
|
12 |
12 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
42 |
$3K |
| 99173 |
|
907 |
875 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
28 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
170 |
152 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
28 |
$2K |
| 90686 |
|
672 |
671 |
$1K |
| 90461 |
|
112 |
96 |
$828.80 |
| 0072A |
|
13 |
13 |
$520.00 |
| 0071A |
|
12 |
12 |
$480.00 |
| 99441 |
|
17 |
17 |
$432.17 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
70 |
58 |
$383.80 |
| 96127 |
|
138 |
122 |
$309.68 |
| 36415 |
Collection of venous blood by venipuncture |
93 |
93 |
$120.47 |
| 90671 |
|
16 |
16 |
$120.00 |
| 90700 |
|
121 |
112 |
$109.90 |
| 96160 |
|
56 |
56 |
$94.08 |
| 86580 |
|
15 |
13 |
$84.45 |
| 90685 |
|
74 |
72 |
$60.69 |
| 90648 |
|
54 |
53 |
$56.82 |
| 36410 |
|
49 |
46 |
$51.99 |
| 90713 |
|
45 |
45 |
$40.64 |
| 96161 |
|
63 |
44 |
$33.26 |
| 3008F |
|
675 |
645 |
$0.00 |
| 91307 |
|
33 |
31 |
$0.00 |
| 99000 |
|
40 |
37 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |