| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,213 |
1,076 |
$73K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
306 |
274 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
449 |
411 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
178 |
159 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$3K |
| 0072A |
|
14 |
14 |
$864.78 |
| 0071A |
|
13 |
13 |
$727.93 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
52 |
$588.75 |
| 96127 |
|
47 |
40 |
$505.57 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
27 |
$437.36 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34 |
14 |
$369.36 |
| 81002 |
|
99 |
84 |
$277.76 |
| 90688 |
|
84 |
79 |
$163.25 |
| 90658 |
|
12 |
12 |
$119.24 |
| 90686 |
|
45 |
44 |
$98.67 |
| 99072 |
|
140 |
124 |
$98.00 |
| 90674 |
|
79 |
77 |
$41.04 |
| 94760 |
|
16 |
16 |
$35.00 |
| 99000 |
|
137 |
114 |
$6.20 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15 |
12 |
$0.11 |
| 91307 |
|
33 |
33 |
$0.00 |