| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,544 |
1,424 |
$122K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
224 |
224 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
82 |
82 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
72 |
72 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
74 |
73 |
$7K |
| 90461 |
|
148 |
148 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
205 |
205 |
$3K |
| 99188 |
|
115 |
115 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
67 |
$886.17 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
108 |
108 |
$844.33 |
| 96127 |
|
48 |
48 |
$349.84 |
| 99050 |
|
16 |
14 |
$192.00 |
| 83655 |
|
18 |
18 |
$190.39 |
| 85018 |
|
18 |
18 |
$37.21 |
| 90670 |
|
91 |
91 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90700 |
|
41 |
41 |
$0.00 |
| 90715 |
|
15 |
15 |
$0.00 |
| 90707 |
|
50 |
50 |
$0.00 |
| 90633 |
|
35 |
35 |
$0.00 |
| 90716 |
|
61 |
61 |
$0.00 |
| 90651 |
|
18 |
18 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |