| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,918 |
12,755 |
$868K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,150 |
2,962 |
$296K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,240 |
1,239 |
$113K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,175 |
1,167 |
$104K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,539 |
5,505 |
$86K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
812 |
790 |
$70K |
| 87428 |
|
998 |
978 |
$45K |
| 99443 |
|
511 |
479 |
$41K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
267 |
264 |
$26K |
| 92551 |
|
3,058 |
3,056 |
$23K |
| 99442 |
|
414 |
390 |
$22K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
868 |
838 |
$12K |
| 99051 |
|
2,163 |
2,125 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,726 |
1,501 |
$8K |
| 99215 |
Prolong outpt/office vis |
26 |
26 |
$4K |
| 99050 |
|
544 |
518 |
$3K |
| 0072A |
|
70 |
70 |
$2K |
| 0071A |
|
65 |
65 |
$2K |
| 0001A |
|
29 |
28 |
$1K |
| 0002A |
|
27 |
27 |
$939.63 |
| 92567 |
|
62 |
62 |
$799.66 |
| 0003A |
|
17 |
17 |
$588.88 |
| 83655 |
|
12 |
12 |
$132.76 |
| 81002 |
|
13 |
13 |
$37.56 |
| 90648 |
|
487 |
487 |
$0.00 |
| 90670 |
|
533 |
533 |
$0.00 |
| 90672 |
|
24 |
24 |
$0.00 |
| 91300 |
|
115 |
100 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90686 |
|
1,167 |
1,167 |
$0.00 |
| 90723 |
|
260 |
260 |
$0.00 |
| 90680 |
|
233 |
233 |
$0.00 |
| 90656 |
|
76 |
76 |
$0.00 |
| 90620 |
|
26 |
26 |
$0.00 |
| 91307 |
|
142 |
127 |
$0.00 |
| 90660 |
|
12 |
12 |
$0.00 |
| 90696 |
|
16 |
16 |
$0.00 |
| 97802 |
|
44 |
44 |
$0.00 |