| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,236 |
1,561 |
$119K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
241 |
218 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
223 |
223 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
172 |
171 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
128 |
126 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
78 |
78 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
447 |
428 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
271 |
266 |
$4K |
| 36416 |
|
547 |
541 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
559 |
553 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
462 |
453 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
200 |
108 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
274 |
272 |
$3K |
| 87081 |
|
392 |
373 |
$2K |
| 81000 |
|
470 |
454 |
$1K |
| 83655 |
|
29 |
27 |
$319.88 |
| 87807 |
|
15 |
13 |
$185.84 |
| 96127 |
|
49 |
49 |
$171.36 |
| 90686 |
|
63 |
63 |
$19.03 |
| 90633 |
|
27 |
27 |
$0.00 |
| 90670 |
|
57 |
57 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90647 |
|
30 |
30 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |