| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
558 |
490 |
$668.16 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
203 |
192 |
$46.00 |
| 90461 |
|
90 |
86 |
$10.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
305 |
302 |
$9.12 |
| 99177 |
|
220 |
217 |
$3.89 |
| 90651 |
|
30 |
30 |
$0.00 |
| 3008F |
|
235 |
235 |
$0.00 |
| 96127 |
|
192 |
192 |
$0.00 |
| 92587 |
|
204 |
204 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109 |
105 |
$0.00 |
| 90620 |
|
36 |
35 |
$0.00 |
| 90619 |
|
40 |
40 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
79 |
79 |
$0.00 |
| 90670 |
|
33 |
32 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
92 |
92 |
$0.00 |
| 90713 |
|
28 |
27 |
$0.00 |
| 90700 |
|
42 |
41 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
28 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
93 |
91 |
$0.00 |
| 90648 |
|
34 |
32 |
$0.00 |
| 90633 |
|
16 |
16 |
$0.00 |
| 96160 |
|
87 |
87 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
57 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
32 |
32 |
$0.00 |