| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,044 |
967 |
$58K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
374 |
363 |
$32K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
174 |
170 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
124 |
121 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
85 |
81 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
161 |
148 |
$5K |
| 90686 |
|
256 |
254 |
$3K |
| 90670 |
|
85 |
84 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
20 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
111 |
111 |
$2K |
| 90698 |
|
88 |
87 |
$1K |
| 90680 |
|
37 |
36 |
$726.17 |
| 90672 |
|
28 |
28 |
$399.49 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
38 |
37 |
$309.80 |
| 99188 |
|
13 |
13 |
$283.79 |
| 87430 |
|
17 |
17 |
$232.11 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$221.76 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
19 |
19 |
$196.54 |
| 90633 |
|
12 |
12 |
$177.10 |
| 99173 |
|
50 |
50 |
$126.19 |
| 36416 |
|
41 |
41 |
$41.73 |