| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,759 |
4,417 |
$309K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,178 |
4,827 |
$216K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,030 |
1,002 |
$66K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
930 |
820 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
696 |
649 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
499 |
473 |
$30K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,073 |
1,986 |
$13K |
| 99215 |
Prolong outpt/office vis |
137 |
113 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,209 |
1,126 |
$7K |
| 90461 |
|
920 |
778 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
971 |
931 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
663 |
593 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
100 |
95 |
$3K |
| 99188 |
|
153 |
144 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
88 |
75 |
$1K |
| 96127 |
|
335 |
323 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
71 |
57 |
$770.73 |
| 99443 |
|
76 |
67 |
$724.28 |
| 99173 |
|
126 |
126 |
$599.84 |
| 92551 |
|
103 |
102 |
$535.75 |
| 90686 |
|
1,425 |
1,376 |
$473.40 |
| 90480 |
|
13 |
13 |
$208.29 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$116.43 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$62.45 |
| 85018 |
|
13 |
12 |
$29.27 |
| 36416 |
|
55 |
50 |
$26.52 |
| 90680 |
|
80 |
79 |
$0.00 |
| 90677 |
|
56 |
56 |
$0.00 |
| 90656 |
|
108 |
105 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90670 |
|
351 |
326 |
$0.00 |
| 90685 |
|
93 |
78 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90648 |
|
107 |
92 |
$0.00 |
| 90715 |
|
40 |
39 |
$0.00 |
| 90649 |
|
13 |
13 |
$0.00 |
| 91322 |
|
13 |
13 |
$0.00 |