| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,494 |
2,380 |
$200K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,264 |
2,079 |
$189K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,223 |
2,135 |
$168K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14,197 |
6,437 |
$138K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,316 |
1,152 |
$90K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,120 |
1,516 |
$40K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,736 |
2,600 |
$19K |
| 90461 |
|
2,619 |
2,111 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
60 |
58 |
$5K |
| 0071A |
|
67 |
66 |
$3K |
| 0072A |
|
61 |
61 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
271 |
221 |
$1K |
| 0001A |
|
23 |
18 |
$576.04 |
| 0002A |
|
15 |
14 |
$542.00 |
| 90480 |
|
38 |
35 |
$450.00 |
| 96161 |
|
119 |
108 |
$160.42 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,354 |
1,284 |
$7.26 |
| 90688 |
|
1,039 |
991 |
$3.20 |
| 90733 |
|
319 |
279 |
$1.66 |
| 90651 |
|
676 |
634 |
$0.02 |
| 90686 |
|
795 |
734 |
$0.02 |
| 90620 |
|
21 |
16 |
$0.01 |
| 90677 |
|
151 |
126 |
$0.00 |
| 90680 |
|
435 |
380 |
$0.00 |
| 91307 |
|
147 |
141 |
$0.00 |
| 96127 |
|
1,990 |
1,856 |
$0.00 |
| 90723 |
|
198 |
168 |
$0.00 |
| 90619 |
|
28 |
26 |
$0.00 |
| 90647 |
|
192 |
165 |
$0.00 |
| 90716 |
|
140 |
133 |
$0.00 |
| 90660 |
|
309 |
304 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
15 |
$0.00 |
| 90633 |
|
263 |
257 |
$0.00 |
| 90670 |
|
1,011 |
912 |
$0.00 |
| 90700 |
|
71 |
71 |
$0.00 |
| 90685 |
|
58 |
53 |
$0.00 |
| 90658 |
|
204 |
201 |
$0.00 |
| 90672 |
|
650 |
621 |
$0.00 |
| 90621 |
|
12 |
12 |
$0.00 |
| 90734 |
|
76 |
76 |
$0.00 |
| 90715 |
|
85 |
80 |
$0.00 |
| 90707 |
|
138 |
131 |
$0.00 |
| 91300 |
|
71 |
52 |
$0.00 |