| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
160 |
160 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
419 |
409 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
250 |
240 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
110 |
110 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
105 |
105 |
$10K |
| 99051 |
|
125 |
122 |
$3K |
| 99188 |
|
132 |
132 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
52 |
48 |
$1K |
| 99072 |
|
100 |
97 |
$934.50 |
| 99173 |
|
228 |
228 |
$561.00 |
| 90698 |
|
79 |
54 |
$429.00 |
| 90670 |
|
79 |
54 |
$429.00 |
| 99177 |
|
39 |
39 |
$297.00 |
| 90687 |
|
54 |
45 |
$286.00 |
| 90688 |
|
55 |
43 |
$253.00 |
| 99000 |
|
17 |
13 |
$227.46 |
| 92551 |
|
229 |
229 |
$220.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
15 |
$165.41 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
37 |
37 |
$115.50 |
| 96161 |
|
13 |
13 |
$42.15 |
| 96127 |
|
19 |
17 |
$22.00 |
| 90680 |
|
24 |
12 |
$0.00 |
| 96160 |
|
13 |
13 |
$0.00 |