| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,272 |
1,183 |
$39K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
338 |
324 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,155 |
917 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
231 |
217 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
500 |
460 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
245 |
231 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
958 |
891 |
$6K |
| 90461 |
|
514 |
440 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
99 |
96 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
90 |
44 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$918.23 |
| 90670 |
|
144 |
133 |
$583.53 |
| 87807 |
|
14 |
13 |
$154.00 |
| 90723 |
|
67 |
65 |
$88.35 |
| 92551 |
|
51 |
50 |
$22.09 |
| 90648 |
|
110 |
109 |
$17.30 |
| 90686 |
|
52 |
52 |
$16.97 |
| 90680 |
|
27 |
27 |
$0.00 |
| 99173 |
|
76 |
72 |
$0.00 |
| 90633 |
|
15 |
13 |
$0.00 |