| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,209 |
893 |
$55K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
203 |
194 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
146 |
130 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
555 |
514 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
244 |
184 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
67 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
307 |
244 |
$5K |
| 90686 |
|
415 |
381 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
38 |
37 |
$3K |
| 96127 |
|
81 |
79 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
76 |
67 |
$975.91 |
| 36416 |
|
64 |
52 |
$279.30 |
| 90670 |
|
13 |
13 |
$83.20 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
30 |
22 |
$0.00 |
| 94760 |
|
67 |
48 |
$0.00 |
| 1003F |
|
254 |
243 |
$0.00 |