| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,318 |
766 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
610 |
265 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
685 |
330 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
234 |
129 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,207 |
637 |
$5K |
| 99199 |
Unlisted special service, procedure or report |
514 |
485 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
20 |
12 |
$279.11 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
12 |
$192.92 |
| 99188 |
|
153 |
89 |
$30.20 |
| 90670 |
|
126 |
72 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |