| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,550 |
1,288 |
$55K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
153 |
152 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,181 |
427 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
106 |
106 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
356 |
162 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$4K |
| 90461 |
|
284 |
242 |
$2K |
| 87428 |
|
22 |
22 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
107 |
102 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 87807 |
|
49 |
48 |
$570.46 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
12 |
$126.80 |
| 90688 |
|
30 |
30 |
$0.20 |
| 90670 |
|
90 |
90 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 99173 |
|
97 |
92 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90680 |
|
27 |
27 |
$0.00 |
| 90698 |
|
15 |
15 |
$0.00 |