| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,326 |
8,936 |
$598K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,166 |
3,794 |
$429K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,006 |
3,280 |
$389K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
9,005 |
6,200 |
$168K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,839 |
1,281 |
$142K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,467 |
1,129 |
$112K |
| 90670 |
|
2,857 |
1,981 |
$37K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
419 |
348 |
$35K |
| 90698 |
|
2,434 |
1,755 |
$29K |
| 90686 |
|
2,622 |
1,935 |
$26K |
| 90680 |
|
2,396 |
1,681 |
$25K |
| 90633 |
|
1,764 |
1,157 |
$19K |
| 99174 |
|
2,263 |
1,423 |
$18K |
| 90744 |
|
1,651 |
1,126 |
$18K |
| 90677 |
|
414 |
355 |
$17K |
| 99460 |
|
181 |
180 |
$9K |
| 90716 |
|
585 |
334 |
$6K |
| 90707 |
|
498 |
287 |
$5K |
| 90647 |
|
820 |
524 |
$5K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
132 |
131 |
$5K |
| 90656 |
|
238 |
218 |
$4K |
| 90723 |
|
589 |
399 |
$4K |
| 90710 |
|
322 |
178 |
$4K |
| 90696 |
|
318 |
170 |
$4K |
| 99381 |
|
31 |
30 |
$3K |
| 90651 |
|
204 |
132 |
$2K |
| 90734 |
|
82 |
60 |
$660.59 |
| 90380 |
|
38 |
20 |
$651.48 |
| 90700 |
|
91 |
53 |
$614.31 |
| 90619 |
|
34 |
29 |
$583.14 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
28 |
28 |
$450.25 |
| 99462 |
|
14 |
12 |
$359.14 |
| 90715 |
|
15 |
15 |
$96.00 |
| 96161 |
|
384 |
222 |
$3.32 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
255 |
250 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,433 |
4,215 |
$0.00 |
| 90461 |
|
4,351 |
2,719 |
$0.00 |