| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,022 |
1,816 |
$84K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,472 |
1,449 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
508 |
474 |
$31K |
| 92588 |
|
870 |
863 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
195 |
195 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
131 |
131 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
979 |
975 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
92 |
91 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
231 |
128 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
284 |
274 |
$2K |
| 95930 |
|
25 |
25 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$848.38 |
| 92587 |
|
49 |
49 |
$584.26 |
| 97802 |
|
27 |
27 |
$433.38 |
| 3008F |
|
30 |
30 |
$300.00 |
| 99401 |
|
42 |
42 |
$284.38 |
| 90686 |
|
643 |
642 |
$192.45 |
| 90670 |
|
137 |
137 |
$181.05 |
| 96127 |
|
56 |
56 |
$168.39 |
| 36416 |
|
28 |
28 |
$50.40 |
| 90461 |
|
557 |
544 |
$0.00 |
| 99072 |
|
37 |
35 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |