| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,476 |
3,788 |
$210K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,165 |
1,161 |
$84K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
650 |
650 |
$54K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
555 |
555 |
$46K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
563 |
537 |
$43K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
388 |
388 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,094 |
1,089 |
$34K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
798 |
775 |
$25K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,234 |
1,219 |
$15K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,028 |
978 |
$11K |
| 90461 |
|
480 |
480 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 90686 |
|
61 |
61 |
$1K |
| 99173 |
|
439 |
439 |
$715.30 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
39 |
39 |
$560.92 |
| 90688 |
|
34 |
34 |
$554.40 |
| 86580 |
|
14 |
12 |
$53.97 |
| 99050 |
|
20 |
20 |
$32.72 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13 |
13 |
$16.50 |
| 81002 |
|
14 |
13 |
$1.19 |