| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,505 |
3,137 |
$205K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,051 |
967 |
$40K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
584 |
523 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
86 |
76 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
65 |
50 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
239 |
229 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
45 |
44 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
25 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
93 |
79 |
$3K |
| 90686 |
|
653 |
613 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
31 |
28 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$1K |
| 99173 |
|
116 |
95 |
$779.77 |
| 90461 |
|
156 |
141 |
$403.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$153.90 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15 |
13 |
$152.49 |
| 90656 |
|
53 |
53 |
$133.65 |
| 99000 |
|
30 |
29 |
$50.83 |
| 36416 |
|
13 |
12 |
$6.00 |
| 90647 |
|
14 |
12 |
$0.00 |