| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,134 |
1,014 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
752 |
704 |
$60K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
167 |
165 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
152 |
150 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
823 |
370 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
278 |
251 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
353 |
346 |
$3K |
| 92561 |
|
100 |
97 |
$3K |
| 90670 |
|
161 |
159 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
34 |
33 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
26 |
$2K |
| 90686 |
|
185 |
184 |
$2K |
| 95117 |
|
222 |
87 |
$2K |
| 90648 |
|
176 |
172 |
$2K |
| 87807 |
|
147 |
132 |
$2K |
| 90685 |
|
104 |
103 |
$1K |
| 90723 |
|
45 |
44 |
$631.79 |
| 90734 |
|
33 |
31 |
$470.04 |
| 99173 |
|
160 |
155 |
$398.86 |
| 92558 |
|
18 |
18 |
$362.34 |
| 90651 |
|
30 |
29 |
$333.30 |
| 90633 |
|
28 |
27 |
$319.00 |
| 90696 |
|
24 |
23 |
$265.10 |
| 90710 |
|
21 |
20 |
$231.00 |
| 90681 |
|
12 |
12 |
$136.40 |