| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,893 |
1,653 |
$71K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
756 |
630 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
941 |
933 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
91 |
91 |
$6K |
| 99401 |
|
467 |
467 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
45 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
175 |
165 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$1K |
| 90461 |
|
49 |
43 |
$686.84 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$684.08 |
| 92551 |
|
106 |
106 |
$617.56 |
| 90686 |
|
29 |
29 |
$275.75 |
| 99173 |
|
395 |
395 |
$5.54 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
16 |
$0.00 |