| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,219 |
4,884 |
$383K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,193 |
2,850 |
$277K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,321 |
2,321 |
$216K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,826 |
4,806 |
$182K |
| 99460 |
|
1,601 |
1,600 |
$142K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,295 |
1,295 |
$120K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,314 |
1,310 |
$90K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
477 |
477 |
$49K |
| 88738 |
|
3,565 |
3,563 |
$16K |
| 54150 |
|
182 |
182 |
$16K |
| 90474 |
|
705 |
705 |
$13K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
123 |
123 |
$12K |
| 99462 |
|
252 |
252 |
$11K |
| 83655 |
|
703 |
702 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
242 |
241 |
$7K |
| 99463 |
|
56 |
56 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
394 |
388 |
$6K |
| 99173 |
|
1,753 |
1,753 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37 |
37 |
$4K |
| 85018 |
|
294 |
294 |
$643.08 |
| 87807 |
|
53 |
52 |
$617.45 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$125.70 |
| 96160 |
|
1,847 |
1,847 |
$0.00 |
| 90633 |
|
403 |
403 |
$0.00 |
| 90681 |
|
459 |
459 |
$0.00 |
| 90670 |
|
1,112 |
1,112 |
$0.00 |
| 90671 |
|
180 |
180 |
$0.00 |
| 90707 |
|
53 |
53 |
$0.00 |
| 90648 |
|
340 |
340 |
$0.00 |
| 90710 |
|
32 |
32 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90647 |
|
659 |
659 |
$0.00 |
| 90686 |
|
436 |
436 |
$0.00 |
| 90716 |
|
68 |
68 |
$0.00 |
| 90723 |
|
937 |
937 |
$0.00 |
| 90651 |
|
33 |
33 |
$0.00 |
| 90696 |
|
17 |
17 |
$0.00 |