| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,344 |
3,043 |
$187K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,877 |
1,699 |
$149K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
561 |
561 |
$44K |
| 96112 |
|
531 |
527 |
$44K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
501 |
501 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,753 |
1,729 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
293 |
293 |
$24K |
| 92587 |
|
1,128 |
1,123 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
268 |
251 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
495 |
490 |
$17K |
| 96111 |
|
131 |
131 |
$8K |
| 90461 |
|
650 |
642 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
380 |
372 |
$4K |
| 90658 |
|
519 |
519 |
$3K |
| 99215 |
Prolong outpt/office vis |
14 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
198 |
196 |
$1K |
| 99173 |
|
627 |
627 |
$1K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
605 |
583 |
$991.00 |
| 96127 |
|
299 |
299 |
$802.84 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
61 |
61 |
$743.82 |
| 90670 |
|
26 |
26 |
$323.66 |
| 87999 |
|
71 |
69 |
$72.50 |
| 90657 |
|
15 |
15 |
$38.41 |