| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
576 |
534 |
$44.44 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,728 |
1,573 |
$40.16 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
205 |
200 |
$10.00 |
| 99173 |
|
667 |
656 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
73 |
72 |
$0.00 |
| 90461 |
|
13 |
13 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
484 |
463 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
541 |
441 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
167 |
165 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
359 |
353 |
$0.00 |
| 90633 |
|
28 |
28 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$0.00 |
| 94760 |
|
946 |
891 |
$0.00 |
| 99058 |
|
199 |
194 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |
| 99000 |
|
80 |
77 |
$0.00 |
| 90651 |
|
62 |
60 |
$0.00 |
| 90686 |
|
288 |
282 |
$0.00 |
| 92583 |
|
199 |
198 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
59 |
56 |
$0.00 |
| 99070 |
|
19 |
18 |
$0.00 |
| 99383 |
|
14 |
14 |
$0.00 |
| 88720 |
|
31 |
24 |
$0.00 |