| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,250 |
2,631 |
$190K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,483 |
2,018 |
$105K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
299 |
284 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
374 |
346 |
$20K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,396 |
1,278 |
$18K |
| 99215 |
Prolong outpt/office vis |
132 |
105 |
$15K |
| 99058 |
|
1,621 |
1,335 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
280 |
226 |
$12K |
| 90686 |
|
976 |
916 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
29 |
$3K |
| 90670 |
|
145 |
126 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
411 |
370 |
$1K |
| 87400 |
|
102 |
86 |
$538.98 |
| 69210 |
|
14 |
12 |
$452.80 |
| 99401 |
|
1,379 |
1,265 |
$442.33 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
27 |
$304.43 |
| 90688 |
|
15 |
15 |
$233.26 |
| 90647 |
|
16 |
12 |
$176.56 |
| 94760 |
|
423 |
352 |
$114.97 |
| 90633 |
|
16 |
13 |
$30.07 |
| 99000 |
|
289 |
255 |
$4.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,373 |
2,025 |
$0.00 |
| 90461 |
|
1,064 |
893 |
$0.00 |
| 90648 |
|
27 |
24 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
147 |
142 |
$0.00 |
| 91307 |
|
17 |
13 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |