| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,179 |
6,619 |
$444K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
542 |
538 |
$52K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,245 |
3,192 |
$42K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
449 |
426 |
$40K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,349 |
804 |
$14K |
| 99000 |
|
852 |
815 |
$10K |
| 87428 |
|
112 |
107 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
38 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
306 |
208 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
98 |
92 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 90480 |
|
12 |
12 |
$359.00 |
| 90474 |
|
24 |
24 |
$206.23 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
13 |
$104.05 |
| 85027 |
|
12 |
12 |
$81.12 |
| 90686 |
|
607 |
601 |
$66.77 |
| 90680 |
|
25 |
25 |
$0.00 |
| 90698 |
|
118 |
118 |
$0.00 |
| 90656 |
|
81 |
81 |
$0.00 |
| 90670 |
|
187 |
184 |
$0.00 |
| 90633 |
|
38 |
38 |
$0.00 |