| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
193 |
193 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
173 |
171 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
129 |
129 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
192 |
186 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
116 |
116 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
49 |
49 |
$4K |
| 90461 |
|
154 |
154 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
217 |
217 |
$3K |
| 96127 |
|
149 |
148 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
77 |
76 |
$810.54 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
38 |
$476.93 |
| 81002 |
|
29 |
29 |
$75.88 |
| 99401 |
|
257 |
257 |
$58.18 |
| 99173 |
|
315 |
315 |
$0.00 |
| 90670 |
|
48 |
48 |
$0.00 |
| 90734 |
|
51 |
51 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90633 |
|
36 |
36 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |
| 90620 |
|
18 |
18 |
$0.00 |
| 90647 |
|
26 |
26 |
$0.00 |
| 90651 |
|
58 |
58 |
$0.00 |
| 90723 |
|
34 |
34 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |