| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,760 |
2,985 |
$175K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,857 |
1,343 |
$137K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
892 |
846 |
$73K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
831 |
772 |
$61K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
211 |
180 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
923 |
260 |
$14K |
| 99058 |
|
1,196 |
853 |
$14K |
| 90688 |
|
1,792 |
1,471 |
$13K |
| 90734 |
|
169 |
148 |
$2K |
| 96127 |
|
166 |
161 |
$2K |
| 90633 |
|
215 |
180 |
$2K |
| 90620 |
|
113 |
89 |
$2K |
| 90651 |
|
102 |
96 |
$1K |
| 90685 |
|
83 |
69 |
$747.10 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
25 |
$434.04 |
| 90670 |
|
15 |
12 |
$301.11 |
| 90700 |
|
27 |
26 |
$260.40 |
| 90648 |
|
17 |
14 |
$140.30 |
| 99173 |
|
29 |
28 |
$119.20 |
| 36416 |
|
25 |
23 |
$98.40 |
| 90713 |
|
15 |
14 |
$96.00 |
| 96161 |
|
816 |
763 |
$32.15 |
| 3725F |
|
350 |
339 |
$0.00 |
| 1003F |
|
716 |
663 |
$0.00 |
| 4035F |
|
112 |
112 |
$0.00 |
| 99051 |
|
17 |
16 |
$0.00 |
| 99411 |
|
12 |
12 |
$0.00 |
| 1036F |
|
474 |
451 |
$0.00 |
| 3008F |
|
1,128 |
1,044 |
$0.00 |
| 4037F |
|
961 |
700 |
$0.00 |
| 97802 |
|
30 |
29 |
$0.00 |