| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,254 |
1,180 |
$73K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
657 |
635 |
$59K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
819 |
485 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
186 |
186 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
118 |
118 |
$9K |
| 92588 |
|
272 |
272 |
$8K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
847 |
847 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
90 |
90 |
$7K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
650 |
633 |
$5K |
| 90461 |
|
140 |
140 |
$4K |
| 96127 |
|
430 |
428 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
334 |
331 |
$4K |
| 99173 |
|
186 |
186 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
393 |
393 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
35 |
$3K |
| 95930 |
|
25 |
25 |
$3K |
| 87081 |
|
215 |
215 |
$1K |
| 83655 |
|
95 |
95 |
$1K |
| 99050 |
|
51 |
51 |
$844.56 |
| 82465 |
|
184 |
184 |
$824.32 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
16 |
16 |
$429.76 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
16 |
16 |
$429.76 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
16 |
$350.40 |
| 93000 |
|
13 |
13 |
$175.63 |
| 87070 |
|
15 |
15 |
$133.20 |
| 82947 |
|
24 |
24 |
$97.20 |
| 81002 |
|
23 |
20 |
$60.72 |