| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,724 |
4,255 |
$180K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,281 |
1,258 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,919 |
1,799 |
$103K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
985 |
965 |
$88K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,050 |
1,000 |
$83K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,696 |
2,404 |
$73K |
| 99429 |
|
1,153 |
1,131 |
$40K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
276 |
276 |
$27K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,869 |
1,750 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,232 |
573 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,474 |
1,443 |
$13K |
| 90461 |
|
1,358 |
1,164 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
256 |
249 |
$3K |
| 99383 |
|
12 |
12 |
$1K |
| 87807 |
|
60 |
59 |
$663.52 |
| S8301 |
Infection control supplies, not otherwise specified |
2,482 |
2,248 |
$390.60 |
| CP001 |
|
31 |
26 |
$299.22 |
| 96380 |
|
13 |
13 |
$263.12 |
| 90707 |
|
174 |
174 |
$0.00 |
| 90648 |
|
969 |
949 |
$0.00 |
| 90670 |
|
783 |
776 |
$0.00 |
| 90734 |
|
42 |
42 |
$0.00 |
| 90633 |
|
275 |
274 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90686 |
|
251 |
236 |
$0.00 |
| 90723 |
|
582 |
567 |
$0.00 |
| 90680 |
|
463 |
451 |
$0.00 |
| 90716 |
|
184 |
184 |
$0.00 |
| 90677 |
|
192 |
181 |
$0.00 |
| 90656 |
|
53 |
53 |
$0.00 |
| 90651 |
|
26 |
26 |
$0.00 |