| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,054 |
823 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
309 |
258 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
634 |
254 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
75 |
68 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
56 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
230 |
173 |
$2K |
| 99381 |
|
14 |
14 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$822.12 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$56.16 |
| 96160 |
|
15 |
14 |
$28.32 |
| 90461 |
|
156 |
133 |
$0.00 |