| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,506 |
1,361 |
$119K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
178 |
163 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
172 |
169 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
923 |
525 |
$11K |
| 90461 |
|
201 |
168 |
$6K |
| 87428 |
|
65 |
63 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
37 |
$4K |
| 99050 |
|
39 |
37 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
95 |
90 |
$980.38 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
31 |
31 |
$384.30 |
| 96127 |
|
50 |
50 |
$156.73 |
| 96160 |
|
51 |
51 |
$152.18 |
| 87807 |
|
12 |
12 |
$120.98 |
| 99000 |
|
12 |
12 |
$31.55 |
| 90686 |
|
15 |
14 |
$7.00 |