| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,216 |
5,648 |
$248K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,975 |
2,713 |
$159K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,675 |
1,726 |
$50K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,299 |
2,168 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,001 |
1,299 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
294 |
283 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
139 |
136 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57 |
57 |
$5K |
| 92551 |
|
937 |
921 |
$2K |
| 90461 |
|
181 |
128 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
83 |
65 |
$711.27 |
| 87807 |
|
49 |
43 |
$533.13 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$214.29 |
| 96160 |
|
69 |
69 |
$107.12 |
| 94760 |
|
329 |
299 |
$24.62 |
| 99173 |
|
1,075 |
1,049 |
$12.50 |
| 99051 |
|
38 |
37 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90670 |
|
17 |
15 |
$0.00 |
| 90686 |
|
137 |
134 |
$0.00 |
| 96127 |
|
96 |
93 |
$0.00 |
| 90651 |
|
30 |
30 |
$0.00 |