| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,095 |
1,985 |
$118K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,359 |
1,213 |
$92K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
359 |
359 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
240 |
239 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
215 |
215 |
$19K |
| 99188 |
|
329 |
329 |
$6K |
| 90686 |
|
363 |
293 |
$4K |
| 90670 |
|
379 |
330 |
$4K |
| 90647 |
|
285 |
248 |
$3K |
| 90723 |
|
265 |
234 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
51 |
$2K |
| 99173 |
|
474 |
473 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
128 |
124 |
$1K |
| 90633 |
|
149 |
126 |
$1K |
| 90734 |
|
25 |
24 |
$1K |
| 90681 |
|
119 |
107 |
$1K |
| 90710 |
|
25 |
25 |
$962.72 |
| 92551 |
|
503 |
502 |
$893.75 |
| 96161 |
|
208 |
206 |
$796.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
79 |
78 |
$585.00 |
| 90696 |
|
24 |
24 |
$399.72 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
230 |
230 |
$311.47 |
| 90700 |
|
13 |
13 |
$142.00 |
| 96127 |
|
122 |
122 |
$70.40 |
| 81000 |
|
13 |
12 |
$52.60 |
| 85018 |
|
16 |
16 |
$0.00 |
| 85013 |
|
16 |
16 |
$0.00 |
| 83655 |
|
16 |
16 |
$0.00 |