| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,681 |
1,532 |
$55K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
342 |
332 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
245 |
239 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
846 |
787 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
138 |
136 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
976 |
470 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
472 |
458 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
199 |
184 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
31 |
30 |
$2K |
| 90649 |
|
71 |
71 |
$838.95 |
| 90461 |
|
123 |
91 |
$767.52 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
14 |
$681.82 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23 |
23 |
$487.16 |
| 96127 |
|
153 |
141 |
$210.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
25 |
$203.84 |
| 90686 |
|
181 |
173 |
$117.84 |
| 81003 |
|
29 |
28 |
$52.69 |
| 96160 |
|
15 |
15 |
$5.06 |
| 90715 |
|
25 |
25 |
$0.00 |
| 90734 |
|
20 |
19 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |