| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
884 |
756 |
$33K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
331 |
275 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
171 |
146 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
125 |
114 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
112 |
107 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
426 |
363 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
44 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
187 |
161 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
205 |
197 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
192 |
89 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
38 |
27 |
$2K |
| 99173 |
|
149 |
127 |
$847.93 |
| 92551 |
|
106 |
91 |
$677.07 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
68 |
62 |
$657.47 |
| 99174 |
|
50 |
38 |
$404.19 |
| 96127 |
|
65 |
57 |
$238.22 |
| 36416 |
|
62 |
59 |
$185.33 |
| 81003 |
|
19 |
14 |
$45.34 |
| 90688 |
|
71 |
64 |
$38.01 |
| 90686 |
|
28 |
28 |
$0.00 |
| 3008F |
|
508 |
441 |
$0.00 |
| 90685 |
|
20 |
20 |
$0.00 |