| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,659 |
6,013 |
$328K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,300 |
1,299 |
$129K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
970 |
969 |
$90K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
987 |
970 |
$89K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
366 |
364 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
132 |
123 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
475 |
460 |
$7K |
| 99215 |
Prolong outpt/office vis |
25 |
24 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
61 |
58 |
$2K |
| 90686 |
|
459 |
457 |
$916.00 |
| 87428 |
|
34 |
34 |
$810.22 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
32 |
$800.06 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,133 |
1,132 |
$748.70 |
| 92551 |
|
1,250 |
1,250 |
$702.30 |
| 99177 |
|
755 |
755 |
$506.16 |
| 96127 |
|
565 |
563 |
$425.04 |
| 90648 |
|
668 |
664 |
$397.00 |
| 96160 |
|
566 |
564 |
$373.68 |
| 90670 |
|
371 |
368 |
$231.00 |
| 90723 |
|
441 |
439 |
$55.00 |
| 96161 |
|
682 |
677 |
$0.00 |
| 90680 |
|
326 |
325 |
$0.00 |
| 90677 |
|
239 |
239 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
266 |
261 |
$0.00 |
| 85018 |
|
24 |
24 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90656 |
|
56 |
56 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 99173 |
|
281 |
281 |
$0.00 |
| 83655 |
|
246 |
246 |
$0.00 |
| 90700 |
|
25 |
25 |
$0.00 |
| G9920 |
Screening performed and negative |
932 |
930 |
$0.00 |
| 90633 |
|
319 |
319 |
$0.00 |
| 0071A |
|
12 |
12 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
24 |
24 |
$0.00 |
| 90661 |
|
54 |
54 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |