| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,383 |
1,131 |
$129K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
294 |
253 |
$38K |
| 90686 |
|
173 |
173 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$3K |
| 92552 |
|
92 |
92 |
$2K |
| 94760 |
|
868 |
728 |
$2K |
| 92551 |
|
141 |
141 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
81 |
76 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$927.60 |
| 99177 |
|
153 |
153 |
$761.29 |
| 96127 |
|
112 |
112 |
$715.95 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
64 |
26 |
$618.52 |
| 99173 |
|
141 |
141 |
$361.40 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
26 |
26 |
$260.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$150.62 |
| W7000 |
|
29 |
29 |
$143.92 |
| 81002 |
|
36 |
34 |
$99.72 |
| 96160 |
|
12 |
12 |
$33.24 |