| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,416 |
1,366 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
649 |
649 |
$60K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
429 |
429 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
409 |
398 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
321 |
321 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
138 |
137 |
$12K |
| 90648 |
|
271 |
271 |
$563.00 |
| 90670 |
|
271 |
271 |
$550.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
32 |
$489.84 |
| 90686 |
|
274 |
257 |
$484.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$483.00 |
| 92551 |
|
492 |
491 |
$210.08 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
277 |
277 |
$168.50 |
| 99177 |
|
455 |
455 |
$79.50 |
| 85018 |
|
71 |
71 |
$66.45 |
| 96127 |
|
182 |
182 |
$30.80 |
| 96160 |
|
182 |
182 |
$26.80 |
| 96161 |
|
230 |
230 |
$0.00 |
| 90723 |
|
141 |
141 |
$0.00 |
| 90680 |
|
80 |
80 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14 |
14 |
$0.00 |
| 99173 |
|
16 |
16 |
$0.00 |
| G9920 |
Screening performed and negative |
68 |
68 |
$0.00 |
| 90633 |
|
38 |
38 |
$0.00 |
| 83655 |
|
13 |
13 |
$0.00 |