| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,685 |
2,123 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
941 |
829 |
$59K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,835 |
1,127 |
$50K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
612 |
543 |
$41K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
680 |
567 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
292 |
242 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,088 |
943 |
$17K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
377 |
187 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
56 |
$5K |
| 96161 |
|
308 |
256 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
291 |
245 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
315 |
250 |
$2K |
| 99173 |
|
281 |
250 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
103 |
$1K |
| 90670 |
|
486 |
398 |
$987.47 |
| 90651 |
|
32 |
28 |
$578.44 |
| 87807 |
|
27 |
26 |
$310.12 |
| 90461 |
|
2,266 |
653 |
$249.36 |
| 96127 |
|
33 |
29 |
$212.47 |
| 90686 |
|
538 |
464 |
$176.76 |
| 90716 |
|
33 |
31 |
$162.22 |
| 90633 |
|
49 |
40 |
$142.01 |
| 36416 |
|
74 |
58 |
$135.38 |
| 36415 |
Collection of venous blood by venipuncture |
33 |
25 |
$58.44 |
| 90707 |
|
48 |
44 |
$45.65 |
| 90647 |
|
228 |
204 |
$22.58 |
| 90723 |
|
241 |
201 |
$22.55 |
| 90680 |
|
213 |
174 |
$22.55 |
| 99000 |
|
268 |
226 |
$0.00 |
| 90685 |
|
16 |
14 |
$0.00 |
| 90734 |
|
16 |
13 |
$0.00 |