| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,562 |
1,504 |
$92K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
946 |
901 |
$82K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,353 |
799 |
$35K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
314 |
314 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
161 |
161 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
165 |
165 |
$14K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,216 |
1,205 |
$12K |
| 92588 |
|
131 |
131 |
$9K |
| 96127 |
|
769 |
759 |
$8K |
| 90461 |
|
212 |
212 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
455 |
446 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
68 |
67 |
$5K |
| 99173 |
|
171 |
171 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
362 |
346 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
90 |
90 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
208 |
207 |
$2K |
| 99177 |
|
40 |
40 |
$900.00 |
| 87081 |
|
129 |
128 |
$857.56 |
| 92552 |
|
28 |
28 |
$725.76 |
| 82465 |
|
152 |
151 |
$648.83 |
| 94760 |
|
217 |
212 |
$549.01 |
| 81002 |
|
193 |
191 |
$503.85 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
40 |
$477.86 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
28 |
28 |
$432.96 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
13 |
$359.48 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
13 |
$359.48 |
| 87807 |
|
27 |
27 |
$318.87 |
| 83655 |
|
27 |
27 |
$309.87 |
| 92587 |
|
13 |
13 |
$217.04 |
| 99051 |
|
12 |
12 |
$198.72 |
| 85018 |
|
33 |
33 |
$80.52 |