| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,597 |
10,908 |
$1.10M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,756 |
2,334 |
$339K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,114 |
2,090 |
$291K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,658 |
1,634 |
$186K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
699 |
688 |
$85K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,444 |
3,347 |
$59K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
305 |
269 |
$17K |
| 99188 |
|
1,736 |
1,704 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
104 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
71 |
71 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
694 |
670 |
$5K |
| 86328 |
|
150 |
140 |
$1K |
| 0001A |
|
32 |
24 |
$958.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
182 |
120 |
$761.94 |
| 0002A |
|
31 |
31 |
$575.00 |
| 90461 |
|
74 |
74 |
$552.00 |
| 90686 |
|
174 |
165 |
$56.35 |
| 85018 |
|
40 |
40 |
$55.65 |
| 83655 |
|
26 |
26 |
$55.52 |
| A4927 |
Gloves, non-sterile, per 100 |
192 |
189 |
$47.18 |
| 90647 |
|
483 |
475 |
$10.12 |
| 90670 |
|
737 |
726 |
$0.00 |
| 90633 |
|
38 |
38 |
$0.00 |
| 99173 |
|
2,130 |
2,023 |
$0.00 |
| 90681 |
|
157 |
150 |
$0.00 |
| 99001 |
|
12 |
12 |
$0.00 |
| 92551 |
|
1,866 |
1,760 |
$0.00 |
| 99000 |
|
893 |
787 |
$0.00 |
| 90723 |
|
171 |
163 |
$0.00 |
| 90651 |
|
26 |
25 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |