| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,327 |
7,201 |
$450K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,225 |
2,790 |
$242K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,823 |
4,538 |
$203K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,669 |
1,592 |
$129K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,572 |
1,522 |
$127K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
846 |
832 |
$69K |
| 99493 |
|
563 |
553 |
$50K |
| 90461 |
|
1,238 |
1,135 |
$47K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,376 |
1,310 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
283 |
277 |
$26K |
| 99494 |
|
268 |
266 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
109 |
103 |
$7K |
| 96127 |
|
1,388 |
1,323 |
$6K |
| 92551 |
|
674 |
644 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
163 |
149 |
$3K |
| 99381 |
|
29 |
27 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
85 |
$1K |
| 99173 |
|
590 |
562 |
$942.36 |
| 90671 |
|
176 |
167 |
$509.54 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
21 |
20 |
$314.76 |
| 99000 |
|
115 |
93 |
$49.00 |
| 94760 |
|
273 |
230 |
$36.33 |
| 90670 |
|
798 |
734 |
$0.09 |
| 90723 |
|
580 |
525 |
$0.07 |
| 90680 |
|
614 |
559 |
$0.07 |
| 90686 |
|
1,298 |
1,123 |
$0.02 |
| 90648 |
|
907 |
807 |
$0.01 |
| 90651 |
|
13 |
13 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
469 |
340 |
$0.00 |
| 90698 |
|
187 |
162 |
$0.00 |
| 90677 |
|
67 |
43 |
$0.00 |
| 90620 |
|
28 |
25 |
$0.00 |
| 36416 |
|
13 |
13 |
$0.00 |
| 90633 |
|
318 |
298 |
$0.00 |
| 90685 |
|
50 |
48 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 99072 |
|
406 |
311 |
$0.00 |