| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,892 |
2,309 |
$117K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,936 |
1,523 |
$115K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,076 |
1,586 |
$63K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,304 |
1,856 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
221 |
168 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
201 |
160 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
389 |
332 |
$10K |
| 92551 |
|
1,515 |
1,192 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
685 |
550 |
$5K |
| 96127 |
|
941 |
738 |
$4K |
| 96160 |
|
1,987 |
1,588 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
26 |
$3K |
| 99173 |
|
1,516 |
1,195 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
43 |
39 |
$2K |
| 3008F |
|
1,545 |
1,265 |
$2K |
| 99402 |
|
196 |
158 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
483 |
378 |
$780.47 |
| 90686 |
|
588 |
497 |
$550.87 |
| 90461 |
|
415 |
335 |
$230.34 |
| 99174 |
|
20 |
12 |
$131.11 |
| 94760 |
|
198 |
173 |
$26.52 |
| 96161 |
|
16 |
14 |
$2.68 |
| 99072 |
|
94 |
79 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |
| 90734 |
|
15 |
13 |
$0.00 |
| S8301 |
Infection control supplies, not otherwise specified |
30 |
24 |
$0.00 |
| 99000 |
|
1,117 |
854 |
$0.00 |
| 90688 |
|
24 |
22 |
$0.00 |
| 99070 |
|
24 |
20 |
$0.00 |