| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,135 |
3,922 |
$231K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,884 |
1,796 |
$131K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,368 |
1,347 |
$75K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,243 |
1,165 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
884 |
878 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
301 |
301 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,990 |
3,870 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,425 |
2,341 |
$11K |
| 87428 |
|
132 |
131 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
191 |
190 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
647 |
409 |
$1K |
| 90686 |
|
1,241 |
1,210 |
$678.12 |
| 83655 |
|
238 |
235 |
$558.99 |
| 90677 |
|
404 |
402 |
$514.33 |
| 0072A |
|
37 |
25 |
$413.81 |
| 0071A |
|
21 |
13 |
$333.81 |
| 87807 |
|
25 |
24 |
$276.23 |
| 90474 |
|
184 |
182 |
$221.01 |
| 90680 |
|
514 |
505 |
$157.39 |
| 90723 |
|
604 |
594 |
$97.97 |
| 90473 |
|
66 |
64 |
$55.25 |
| 99188 |
|
16 |
16 |
$53.61 |
| 81003 |
|
20 |
18 |
$48.96 |
| 99177 |
|
298 |
295 |
$46.24 |
| 91307 |
|
56 |
50 |
$40.01 |
| 0001A |
|
13 |
12 |
$40.00 |
| 85018 |
|
87 |
86 |
$39.50 |
| 90656 |
|
199 |
197 |
$35.68 |
| 90633 |
|
149 |
147 |
$32.76 |
| 96381 |
|
13 |
13 |
$14.49 |
| 90648 |
|
896 |
877 |
$12.80 |
| 36416 |
|
27 |
27 |
$9.57 |
| 90651 |
|
165 |
164 |
$0.00 |
| 90696 |
|
26 |
26 |
$0.00 |
| 90480 |
|
13 |
13 |
$0.00 |
| 90710 |
|
38 |
38 |
$0.00 |
| 90670 |
|
468 |
454 |
$0.00 |
| 90734 |
|
73 |
72 |
$0.00 |
| 90715 |
|
25 |
25 |
$0.00 |
| 90707 |
|
24 |
24 |
$0.00 |