| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,839 |
3,439 |
$180K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,126 |
1,928 |
$71K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
884 |
831 |
$68K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
663 |
617 |
$49K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
620 |
579 |
$49K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,206 |
2,188 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
171 |
162 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,337 |
1,082 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
830 |
379 |
$9K |
| 99429 |
|
205 |
200 |
$7K |
| 90461 |
|
957 |
744 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
283 |
263 |
$3K |
| 87807 |
|
104 |
98 |
$795.85 |
| 99000 |
|
104 |
93 |
$747.36 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
24 |
$602.17 |
| G0402 |
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment |
26 |
26 |
$475.00 |
| 90688 |
|
1,114 |
1,064 |
$327.56 |
| 96160 |
|
150 |
150 |
$258.76 |
| 90686 |
|
17 |
17 |
$190.30 |
| 92587 |
|
75 |
72 |
$28.24 |
| 90648 |
|
155 |
148 |
$1.00 |
| 90670 |
|
276 |
258 |
$1.00 |
| 90651 |
|
72 |
70 |
$1.00 |
| 99188 |
|
195 |
183 |
$0.00 |
| 90710 |
|
86 |
81 |
$0.00 |
| 90633 |
|
46 |
44 |
$0.00 |
| 99173 |
|
110 |
106 |
$0.00 |
| 90734 |
|
15 |
12 |
$0.00 |
| 90723 |
|
39 |
38 |
$0.00 |
| 90680 |
|
86 |
82 |
$0.00 |
| 90620 |
|
13 |
12 |
$0.00 |