| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,249 |
4,002 |
$150K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,386 |
2,222 |
$123K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,127 |
2,991 |
$66K |
| G9001 |
Coordinated care fee, initial rate |
217 |
208 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
147 |
145 |
$6K |
| 90461 |
|
63 |
61 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
667 |
556 |
$2K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
18 |
18 |
$578.00 |
| 90686 |
|
1,753 |
1,677 |
$216.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$198.36 |
| 90656 |
|
151 |
147 |
$0.00 |