| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,975 |
3,712 |
$148K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,779 |
1,697 |
$92K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
560 |
559 |
$49K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
608 |
600 |
$48K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,125 |
1,090 |
$27K |
| S8301 |
Infection control supplies, not otherwise specified |
1,737 |
1,644 |
$25K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,243 |
2,184 |
$25K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,646 |
1,576 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
185 |
179 |
$14K |
| 94375 |
|
389 |
379 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,297 |
1,061 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
974 |
337 |
$10K |
| 81025 |
|
1,279 |
1,173 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
536 |
261 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
607 |
314 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
630 |
610 |
$5K |
| 90461 |
|
395 |
302 |
$3K |
| 96160 |
|
1,081 |
1,072 |
$2K |
| 0071A |
|
64 |
52 |
$2K |
| 82947 |
|
525 |
508 |
$2K |
| 0072A |
|
42 |
38 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$923.40 |
| 83655 |
|
52 |
52 |
$528.84 |
| 0001A |
|
12 |
12 |
$480.00 |
| 99080 |
|
15 |
15 |
$411.60 |
| 90686 |
|
1,035 |
1,015 |
$402.88 |
| 81002 |
|
12 |
12 |
$35.04 |
| 96161 |
|
312 |
306 |
$20.07 |
| 86580 |
|
28 |
26 |
$0.28 |
| 90657 |
|
27 |
27 |
$0.00 |
| 91307 |
|
124 |
87 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 91300 |
|
128 |
116 |
$0.00 |
| 90658 |
|
296 |
289 |
$0.00 |
| 90715 |
|
13 |
12 |
$0.00 |