| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,921 |
4,890 |
$337K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,303 |
2,963 |
$298K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,236 |
5,797 |
$212K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,187 |
2,058 |
$187K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,311 |
2,066 |
$183K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,820 |
1,550 |
$143K |
| T1026 |
Intensive, extended multidisciplinary services provided in a clinic setting to children with complex medical, physical, mental and psychosocial impairments, per hour |
472 |
450 |
$130K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
970 |
896 |
$86K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,059 |
3,472 |
$58K |
| 99215 |
Prolong outpt/office vis |
456 |
408 |
$56K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,374 |
1,301 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
510 |
246 |
$8K |
| 0072A |
|
126 |
125 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
520 |
441 |
$7K |
| 0071A |
|
144 |
114 |
$7K |
| 90670 |
|
1,083 |
1,039 |
$7K |
| 99383 |
|
55 |
53 |
$6K |
| 90688 |
|
755 |
665 |
$4K |
| 96127 |
|
309 |
286 |
$4K |
| 90461 |
|
2,721 |
2,535 |
$4K |
| 90651 |
|
243 |
237 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
90 |
78 |
$3K |
| 90619 |
|
100 |
90 |
$3K |
| 90710 |
|
78 |
78 |
$3K |
| 90686 |
|
1,819 |
1,759 |
$3K |
| 90677 |
|
183 |
182 |
$2K |
| 36416 |
|
1,165 |
1,079 |
$2K |
| 85018 |
|
733 |
670 |
$2K |
| 90734 |
|
89 |
88 |
$1K |
| 0004A |
|
31 |
31 |
$1K |
| 99382 |
|
12 |
12 |
$1K |
| 90681 |
|
253 |
238 |
$1K |
| 90633 |
|
537 |
517 |
$1K |
| 90647 |
|
754 |
729 |
$1K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
33 |
33 |
$1K |
| 90723 |
|
291 |
283 |
$897.30 |
| 87807 |
|
65 |
61 |
$735.91 |
| 90656 |
|
239 |
238 |
$517.66 |
| 90700 |
|
273 |
266 |
$468.00 |
| 90696 |
|
48 |
48 |
$446.11 |
| 90715 |
|
84 |
83 |
$320.40 |
| 99000 |
|
211 |
206 |
$119.69 |
| 90687 |
|
119 |
119 |
$70.23 |
| 96160 |
|
139 |
138 |
$36.87 |
| 91300 |
|
66 |
61 |
$0.00 |
| 91307 |
|
271 |
224 |
$0.00 |
| 96161 |
|
96 |
66 |
$0.00 |