| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,587 |
14,219 |
$990K |
| T1015 |
Clinic visit/encounter, all-inclusive |
33,625 |
24,785 |
$494K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,713 |
4,569 |
$400K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,101 |
1,723 |
$143K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
898 |
727 |
$68K |
| 59426 |
|
476 |
204 |
$29K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
867 |
645 |
$26K |
| 59425 |
|
386 |
238 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
261 |
254 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
208 |
156 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
705 |
593 |
$9K |
| 81003 |
|
1,880 |
1,087 |
$2K |
| 81025 |
|
92 |
64 |
$712.06 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
28 |
$186.78 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
13 |
$91.17 |
| 87210 |
|
14 |
12 |
$69.76 |
| 90686 |
|
48 |
27 |
$62.20 |
| 83986 |
|
17 |
15 |
$51.61 |
| 1160F |
|
577 |
515 |
$0.00 |
| 1159F |
|
583 |
524 |
$0.00 |
| 3078F |
|
13 |
12 |
$0.00 |