| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,658 |
2,465 |
$127K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
223 |
223 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
160 |
158 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
41 |
41 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
38 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
136 |
129 |
$2K |
| 90686 |
|
302 |
284 |
$352.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$324.74 |
| 92551 |
|
540 |
540 |
$218.40 |
| 96127 |
|
310 |
310 |
$194.48 |
| 96160 |
|
334 |
334 |
$165.40 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
58 |
58 |
$21.56 |
| 90670 |
|
15 |
15 |
$0.00 |
| G9920 |
Screening performed and negative |
168 |
168 |
$0.00 |
| 90461 |
|
13 |
13 |
$0.00 |
| 90648 |
|
45 |
45 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
34 |
34 |
$0.00 |
| 90661 |
|
76 |
76 |
$0.00 |
| 99173 |
|
51 |
51 |
$0.00 |
| 1160F |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
129 |
128 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90656 |
|
34 |
34 |
$0.00 |
| 90651 |
|
28 |
28 |
$0.00 |
| 90677 |
|
17 |
17 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |