| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,755 |
4,418 |
$224K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,082 |
1,067 |
$118K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
848 |
837 |
$87K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,219 |
1,167 |
$82K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
356 |
319 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
188 |
185 |
$22K |
| 90686 |
|
980 |
970 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
274 |
270 |
$2K |
| 90698 |
|
112 |
111 |
$2K |
| 90685 |
|
96 |
96 |
$2K |
| 90670 |
|
67 |
67 |
$1K |
| 85018 |
|
680 |
669 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
114 |
110 |
$1K |
| 96160 |
|
245 |
234 |
$615.14 |
| 90710 |
|
27 |
27 |
$592.92 |
| 90680 |
|
17 |
17 |
$351.36 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
22 |
22 |
$289.30 |
| 90633 |
|
13 |
13 |
$285.48 |
| 90744 |
|
12 |
12 |
$263.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
704 |
414 |
$197.55 |
| 81000 |
|
54 |
52 |
$186.58 |
| 90461 |
|
149 |
128 |
$109.80 |
| 91307 |
|
51 |
49 |
$0.00 |