| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
657 |
596 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
800 |
792 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
180 |
163 |
$14K |
| 92552 |
|
652 |
642 |
$14K |
| 94375 |
|
358 |
355 |
$10K |
| 92550 |
|
294 |
287 |
$4K |
| 92568 |
|
207 |
195 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$840.16 |
| 81000 |
|
304 |
302 |
$724.11 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
45 |
$367.24 |
| 99173 |
|
118 |
118 |
$129.24 |
| 90658 |
|
17 |
17 |
$109.44 |
| 87070 |
|
36 |
36 |
$104.26 |
| 87184 |
|
36 |
36 |
$73.42 |
| 92567 |
|
203 |
197 |
$72.18 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24 |
24 |
$71.07 |