| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,514 |
1,387 |
$71K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
253 |
248 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
211 |
211 |
$17K |
| 99051 |
|
420 |
393 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
54 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$1K |
| 90686 |
|
187 |
165 |
$901.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
30 |
$398.46 |
| 92551 |
|
139 |
139 |
$369.48 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
426 |
422 |
$113.93 |
| 99177 |
|
64 |
64 |
$113.43 |
| 96127 |
|
24 |
24 |
$22.88 |
| 96160 |
|
12 |
12 |
$5.36 |
| 90661 |
|
20 |
20 |
$0.00 |
| 90656 |
|
39 |
39 |
$0.00 |