| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
300 |
289 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
184 |
179 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
472 |
236 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
40 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
32 |
28 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
125 |
122 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
101 |
75 |
$745.62 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
48 |
24 |
$639.40 |
| 90461 |
|
45 |
41 |
$476.95 |
| 99429 |
|
14 |
14 |
$431.20 |
| 99001 |
|
12 |
12 |
$58.54 |
| 90670 |
|
12 |
12 |
$0.00 |
| 96127 |
|
52 |
46 |
$0.00 |
| 90686 |
|
191 |
190 |
$0.00 |