| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,759 |
4,710 |
$187K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,127 |
1,031 |
$86K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
649 |
571 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,962 |
1,826 |
$39K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
487 |
475 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
506 |
470 |
$24K |
| 92587 |
|
1,192 |
1,152 |
$18K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
770 |
665 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
152 |
149 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
801 |
777 |
$8K |
| 99051 |
|
1,048 |
984 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
65 |
65 |
$5K |
| 99383 |
|
29 |
29 |
$2K |
| 90716 |
|
363 |
335 |
$2K |
| 90707 |
|
450 |
423 |
$1K |
| 83655 |
|
96 |
96 |
$807.50 |
| 85018 |
|
470 |
454 |
$733.86 |
| 90670 |
|
576 |
525 |
$540.15 |
| 90633 |
|
472 |
402 |
$480.45 |
| 90696 |
|
64 |
62 |
$296.10 |
| 90461 |
|
298 |
261 |
$252.00 |
| 90686 |
|
336 |
328 |
$215.64 |
| 87807 |
|
25 |
25 |
$190.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26 |
25 |
$168.48 |
| 90700 |
|
180 |
171 |
$129.00 |
| 81003 |
|
30 |
29 |
$58.58 |
| 90648 |
|
422 |
378 |
$20.52 |
| 90734 |
|
29 |
26 |
$0.00 |
| 99174 |
|
588 |
529 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
160 |
108 |
$0.00 |
| 90723 |
|
327 |
312 |
$0.00 |
| 36416 |
|
114 |
109 |
$0.00 |
| 96127 |
|
68 |
63 |
$0.00 |
| 90680 |
|
245 |
234 |
$0.00 |
| 90651 |
|
29 |
28 |
$0.00 |